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ASC Provider Briefing - 16 December 2022
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Dear Care Provider Colleagues,
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Welcome to this week's briefing.
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We hope you are staying warm in the cold weather.
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This week in the briefing: details about the updated Infection Prevention Control guidance, information about acute respiratory infections in care settings, recruiting shared decision maker council chairs, a few reminders, and an invitation to homecare contract engagement events in January.
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Please find the latest news and updates from Adult Social Care below:
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IPC Guidance
The Department of Health and Social Care has updated the infection prevention and control guidance for social care. This can be found at the link below, but the highlights are as follows:
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We continue to strongly urge all staff and residents to continue to come forward for vaccination. We know that the success of the initial vaccination programme helped bring the pandemic numbers down and has been responsible for saving many lives. We need to ensure that we continue to follow the science and come forward for booster vaccinations as they become available.
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Gloves and aprons should be worn for close contact with a person who has suspected or confirmed Covid or when cleaning their room. Gowns are no longer required. Reusable eye protection may also be worn and cleaned after each use.
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Masks do not need to be routinely worn in care settings or when providing care in peoples homes. They should however be worn:
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- if the person being cared for is known or suspected to have COVID-19 (recommended Type IIR fluid-repellent surgical mask)
- if the member of staff is a household or overnight contact of someone who has had a positive test result for COVID-19
- if the care setting is in an outbreak.
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Masks may also be worn if this is the individuals preference or if after risk assessment the provider considers it necessary, such as with large gatherings.
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FFP3 masks are only required when undertaking an Aerosol Generating Procedure on a person with suspected or confirmed COVID-19 infection,
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Staff should continue to have access to lateral flow test kits at home. These should be used when the individual becomes unwell or is symptomatic of covid. These staff should take 2 lateral flow tests 48 hours apart. If the lateral flow test result is negative, they should take another lateral flow test 48 hours later, staying away from work during this time. If the second test is negative they can return to work. If positive further tests should be undertaken on day 5 and 6, two consecutive negative results means the staff member can return to work. A single negative test on or after day 10 means the staff member can return to work. They may also return after day 14 irrespective of test result. PCR are not required.
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Staff who are household or overnight contacts of someone who have had a positive COVID-19 test result should discuss ways to minimise risk of onwards transmission with their line manager. This may include applying measures known to reduce risk such as distancing, maximising ventilation, wearing a mask etc.
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Residents should take both of the following:
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- 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
These tests should be provided by the care home if the individual is being admitted from the community. These tests will be provided by the hospital if the individual is being discharged into the care home.
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If an individual tests positive on either of these tests and continues to be admitted to the care home, they should be isolated on arrival and follow the guidance on care home residents who are symptomatic or test positive for COVID-19.
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If an individual tests positive prior to discharge, they can be admitted to the care home, if the home is satisfied they can be cared for safely. They should undertake daily lateral flow testing from day 5 and can cease isolation following two negative lateral flow tests taken 24hrs apart or at day 10 if they no longer have a fever.
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An outbreak consists of 2 or more positive or clinically suspected linked cases of COVID-19, within the same setting within a 14-day period (this means where the cases are linked to each other and transmission in the care setting is likely). This applies to both staff and residents and includes PCR and lateral flow test results.
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If an outbreak is suspected, the care home should undertake a risk assessment as soon as possible to determine if the situation can be considered an outbreak and if outbreak management measures are needed. The provider should inform the HPT or other local partner of a suspected outbreak, but they are not required to wait for advice from the HPT (or other relevant local partner) should they feel able to initiate the risk assessment independently.
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More autonomy for all care settings in assessing and managing their own outbreaks
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Guidance wording has changed so that care settings are able to risk assess whether they have unlinked cases or an outbreak, including a short guide to whether cases are likely to be linked to transmission in the setting or not. The guidance now explicitly says that they should not wait for HPT input to begin basic outbreak control measures and the wording for outbreak measures is much more risk-centred e.g. recommending proportionate reductions in communal activities, visiting, new admissions.
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It still says though, that all outbreaks should be reported to the HPT.
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The word “cluster” has been taken out of the national guidance altogether.
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However, the SW HPT care programme team’s view is that there is still a place for declaring a likely cluster as opposed to an outbreak i.e. in the grey area between definitely unlinked cases and where transmission in the setting is highly likely. Then we advise two rounds of outbreak testing (all staff and resident LFD and PCR) plus rapid response LFD testing for staff and if all negative, lift outbreak restrictions.
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The screening questions in our Care OBRA tool have been evidenced as highly predictive of whether 2 or more cases in a care setting equate to transmission within the setting or not. They are not 100% predictive but we have the safety net of outbreak testing to identify whether there are any more cases in that setting. Therefore, we (SW HPT) will shortly be moving to no longer undertaking cluster calls, but using the screening questions in the Care OBRA to differentiate between likely clusters and outbreaks. Then standard emails (cluster or outbreak) can be sent without the need for a cluster call.
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For care homes with 10 or fewer residents there is a change in the Testing guidance. Evidence shows that spread amongst residents in small household type environments is likely to be swift and also that these settings tend to house less vulnerable, younger people. Therefore, the new recommendation is to assess the appropriateness of rapid response outbreak testing and NOT to do recovery testing at all. Outbreak measures can be lifted once all those affected are out of their isolation periods.
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There is already an appendix in the SW SOP that advises on this topic. We will be incorporating it into the main body of the SOP over the course of the next week, as well as updating template emails.
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Acute Respiratory Infections in Care Settings
Flu activity is rising across the country and the SW
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- Activity increasing - SARI watch admissions at medium levels of activity, RCGP surveillance indicators also at medium levels
- 20% positivity in DataMart (about 1 in 3 for school age children)
- Highest admission rates in <5>85’s
- Increasingly looking like an H3 season with relatively little H1 (vaccine is good match for H3)
- If flu co-infection with Gp A Strep – risk of iGAS although influenza not the most commonly detected viral co-infection (RSV more common).
- Please continue to promote vaccine uptake.
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Recruiting ICB social care Shared Decision Making Council Chairs
As you may know, Deb Sturdy and I are working with the Florence Nightingale Foundation to establish Shared Decision-Making Councils for adult social care in every ICS in England, to ensure the professional voice of nurses in this sector are heard and for the councils to act as a touchstone to support ICS’ in their work.
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We are now welcoming applications from social care nurses for the role Council chairs and would ask that you share this email and information with relevant colleagues to encourage people to apply - you can find details of how social care colleagues can apply here.
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Once individuals have been identified as chairs, we will be in contact to facilitate introductions between chairs and ICBs to discuss their future Council meetings. The agenda and frequency of Council meetings are for ICBs and the chairs to decide together. However, we envisage these to be no more than three to four times a year.
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We hope this will help ICS’ deliver the shared vision for an integrated system, one that is inclusive of the social care sector’s voice and its role in delivering high quality care.
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If you would like a conversation about establishing connections to local care providers, or possible routes to identify a chair for your Council, you can find details of local area teams here. For further details about the programme, please contact Lucy Brown at: lucy@florence-nightingale-foundation.org.uk
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Deborah Sturdy and Hilary Garratt
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Reminder: Winter Pressure Mental Health Care Pods
Due to the release of winter pressure monies, we are looking for an existing complex care CQC registered provider to deliver a block hours arrangement.
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This is for individuals with a primary need of Mental Health and living in South Somerset and in the Mendip areas. This is most likely to be in the individual’s home but could require support to be delivered in other environments e.g. Homeless hostels, YMCA.
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The team primary focus will be to facilitate discharges from psychiatric wards and prevent admission to hospital by providing timely support following intervention/assessment from the health colleagues. The elected provider will be expected to work in partnership with all involved and link individuals to other community based services to maximise positive outcomes.
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This is a finite pot of money available now until the end of March. There is some flexibility around additional payment for travel as we recognise that the challenges recruitment and retention bring in these areas.
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There will be an expectation that this contract is in place before Christmas so if you have capacity and would like some guaranteed revenue for the last quarter of the year please express your interest to Amy Alexander and Celine Antier via MHSCCCommissioning@somerset.gov.uk
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Winter Pressure Supported Living provision - Mendip
For those Mental Health Providers looking to expand their supported living provision, we are looking for expressions of interest to set up a provision in the Mendips locality for Males who experience mental health issues who may also have comorbid substance misuse. The age profile for this service will be 18-40.
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The provision will aim to support in the first instance the discharge of individuals who are currently on psychiatric wards.
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Winter monies of a maximum of £50k are available to either support existing providers to expand their provision to meet this need or for new providers to get a new provision off the ground.
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This £50k would not be recurring and expressions of interest should demonstrate how this money will be used to get the provision going.
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There will be expectations that this service is ready to receive individuals by the end of January at the latest.
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Reminder: SEND strategy consultation
We are currently consulting on Somerset’s new SEND Strategy that will define the priorities and approach to improving outcomes for children and young people with SEND over the next three years.
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The consultation runs until 23 December. We want to have as many people’s views from across the system to inform the development of the strategy.
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Latest Covid-19 Outbreak update
(Friday 16 December 2022)
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Please continue to take infection, prevention, and control precautions.
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Events
Next month’s LEM:
1.Kirsty Withers Dementia Matron
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- Delirium presentation, Q&A
- MCA/BI Somerset Competency framework, Q&A
4. Emma Savage, Deputy Director of Quality and Improvement, Integrated Care Board presenting:
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- Patient Safety Incident Response Framework
LEM topics and transference of care discussion topics:
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Please do get in touch if you would like to see certain speakers, have particular health and social care colleagues in attendance, provide topics for discussion or offer to be a guest speaker sharing a good news story. It is so important to share the positive experiences. The LEM is the Care Providers of Somerset Resource so please get in touch: ASCContractsandQualityMonitoring@somerset.gov.uk
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Wishing you all a very merry Christmas and a happy new year. I look forward to seeing you in 2023.
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Rachel Caunce, Care Provider Support Officer
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Homecare in Somerset
The current contracts for Homecare services in Somerset expires at the end of March 2024 and we have a commissioning plan underway to have a new contract in place from April 2024.
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Is it considered that the current model and demand pressures have led to a service which isn’t as efficient as it could be and that the recommissioning of the service will provide an opportunity to look at different models that reduce inefficiencies and bring better outcomes for Somerset’s residents.
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The overall aim is to co-produce a more localised place-based offer which creates an environment for more collaborative working.
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Further to the initial engagement sessions held during October, we would like to continue the conversations by holding further sessions during January, with a view to focussing in on some of the available options for the commissioning and delivery of homecare services in the future.
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Soft Market Testing Event
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Soft Market Testing events will be held on 17th, 18th, 24th & 25th January 2023 between 10:00 and 12:00. Somerset County Council are inviting organisations, that might be interested in delivering these services either individually or in partnership with others to attend. The event will be an opportunity to inform and shape future options. Somerset County Council are keen to hear feedback from a range of providers as part of the wider consultation for this service.
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Organisations that take part will not be advantaged or disadvantaged in any way in any potential future formal procurement. Commercial confidentiality will be respected. This notice does not represent a formal commitment by Somerset County Council to undertake a procurement procedure.
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- Date: Tuesday 17th January 2023
- Time: 10:00 to 12:00
- Venue: Bridgwater area
- Date: Wednesday 18th January 2023
- Time: 10:00 to 12:00
- Venue: Yeovil area
- Date: Tuesday 24th January 2023
- Time: 10:00 to 12:00
- Venue: Glastonbury area
- Date: Wednesday 25th January 2023
- Time: 10:00 to 12:00
- Venue: Taunton area
Please respond by the deadline of 12:00pm on 10th January 2023 if you wish to attend.
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SCC reserves the right to cancel or re-arrange these events at its own discretion.
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Upcoming Event Reminders
- Care Provider Learning Engagement Meeting, 3rd January, 2-4pm.
- Conference: Making Research Matter in Practice, Wednesday 8th February 2023, in person (Bristol) and virtual. Details on Eventbrite.
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Please continue to share or promote these briefings and our webpage to others in your organisations.
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Our incident room mailbox and contact details (see below) remains operational during core working hours so please get in touch if you have any urgent concerns or queries we can look to assist you with.
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Somerset’s Provider Engagement Team
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Adult Social Care (ASC) COVID19 Response Team
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