Nottingham & Nottinghamshire Covid-19 Response Care Homes and Home Care Toolkit

The Toolkit provides an overview of key areas care home and homecare staff should be familiar with. It is intendedto be used as an electronic quick reference guide suitable for use with adults in receipt of care provision.

Last updated 07.09.2020Always make sure you have the latest guidance by visiting:https://www.gov.uk/coronavirushttps://www.scie.org.uk/care-providers/coronavirus-covid-19

3. Admissons and Discharge

8. Testing & Swabbing

5. Infection Prevention Control

4. Personal Protective Equipment (PPE) 13. Emergency Care and Treatment including palliationand end of life plans

12. Medications and Symptom Management

15 &16. Essential contacts and system pathways

14. Death Verification and Grief and BereavementSupport

17. Document Information & Acknowledgements

11. Recognising and Responding to Deterioration

9 & 10. Track and Trace

2. Whats New?

6 & 7. Visiting information

https://www.gov.uk/coronavirushttps://www.scie.org.uk/care-providers/coronavirus-covid-19

Whats New? key Messages

Updated guidance! -Admission and Care of Residents in a Care Home during COVID-19 - Access it here

EHCH & Ageing Well - So what for the sector?

PPE - Local & National portal to request Emergency supplies

How to access the relief workforce

Changes to the grief line operating hours

Whole home testing

Updates in this version:

https://www.gov.uk/government/news/regular-retesting-rolled-out-for-care-home-staff-and-residentshttps://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/912750/Admission_and_care_of_residents_in_a_care_home_during_COVID-19.pdfhttps://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/912750/Admission_and_care_of_residents_in_a_care_home_during_COVID-19.pdf

Admissions (including re-admissions) and admissions from the community to social care settingsshould not put other individuals entering or living at the address at risk.All individuals will be tested prior to discharge from hospital or prior to admission/re-admission tosocial care provision. Discharge and admission should not be delayed – test results pending Many care providers will be able to accommodate admissions through excellent IPC and  PPEmanagement, effective isolation strategies and cohorting policies.For some care providers effective isolation or cohorting may not be appropriate or available – in thesecases the individuals’ local authority will be asked to secure alternative appropriate accommodationand care for the remainder of the isolation periodA risk assessment is required to ensure a safe discharge can take place (IPC teams can help with this)

Symptomatic residents or those who have been in contact with a possible case should ideally be isolatedin single occupancy rooms for 14 days. Where this is not practical, cohort symptomatic and confirmed residents (red zones) together in multi-occupancy rooms or one area of the home, away from well residents (green zones). Residents with suspected COVID-19 should be cohorted only with other residents with suspected COVID-19.Residents with suspected COVID-19 should not be cohorted with residents with confirmed COVID-19. Do not cohort suspected or confirmed patients next to immunocompromised residents. When transferring symptomatic residents between rooms, the resident should wear a surgical face mask.Clearly sign the rooms by placing Infection Prevention and Control (IPC) signs, indicating droplet andcontact precautions at the entrance of the room. Key staff should be allocated to look after only unwell or positive residents and if possible use a separateentrance. These staff must not move zones or have breaks with staff on other zones. Key staff in redzones could be ones who have previously tested positive. Supporting information on zones reinforced through staff allocation and rotation is available hereUseful guidance for supporting those with Learning disabilities and Autism can be accessed here or forthose living with dementia, or who walk with purpose, can be accessed hereIsolation of contacts individually in single rooms for 14 days after exposure to a possible or confirmedcase should be carefully monitored for any symptoms of COVID-19 during the 14-day period Cohorting of contacts within one unit rather than individually: Consider this option if isolation in singlerooms is not possible due to shortage of single rooms when large numbers of exposed contacts areinvolved. Residents who have not had any exposure to the symptomatic case can be cohorted separately inanother unit within the home away from the cases and exposed contacts. Clinically extremely vulnerable residents should be in a single room with ensuite facilities

More than one case - cohorting of all symptomatic residents:

Notify PHE on 0344 225 4524 or email phe.crc.eastmidlands@nhs.net You can contact your LA/CCG for practical support about what to do next/how to manage, support withrisk assessment etc. Email the IPC teams. Nottinghamshire County - MACCG.IPC@nhs.net or Nottingham Cityncp.ipct@nhs.net and they will call you back in office hours.During evenings and weekends to report an outbreak or gain urgent advice contact PHE on 03442254524.If you have any other  COVID-19 query, please contact the Incident Control Centre on 0115 8831111 oremail on nnestccg.nottsincidents@nhs.net. Phone lines operate 8am to 8pm 7 days per week

https://www.gov.uk/government/publications/coronavirus-covid-19-hospital-discharge-service-requirements https://www.gov.uk/government/publications/coronavirus-covid-19-adult-social-care-action-plan/covid-19-our-action-plan-for-adult-social-care  https://www.gov.uk/government/publications/coronavirus-covid-19-admission-and-care-of-people-in-care-homes

Managing admissions and discharges

Safe admission/discharge principles from community & NHS to social care settings

Cohorting and zoning

Managing a Coronavirus (Covid-19) outbreak!2 confirmed or clinically suspected cases within 14 days

Published guidance

Result Isolation (if isolation is not possible (See cohorting/Zoning)Negative COVID-19 result prior to discharge or onadmission including test resultspending

Isolate for 14 days from arriving in the home. Do not rely on anegative results, this is only accurate on the day it is taken, theresident may become positive later

Positive COVID -19 result and14 days isolation completed.No symptoms

No further isolation required in the home

Positive COVID -19 result, withNO symptoms and 14 daysisolation NOTcompleted

Complete the 14 days isolation in the home. 14 days is countedfrom the date the positive test is taken Example - If 10 dayssince positive result in hospital, four days are left to completein the home.

Managing suspected/potential new caseIsolate & Test

http://bushproof.com/https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0031_Specialty-guide_LD-and-coronavirus-v1_-24-March.pdfhttps://www.scie.org.uk/care-providers/coronavirus-covid-19/dementia/care-homes?utm_campaign=11544303_SCIELine+14+May&utm_medium=email&utm_source=SOCIAL+CARE+INSTITUTE+FOR+EXCELLENCE+&utm_sfid=003G000000w1tbsIAA&utm_role=Regulator+or+Inspector&dm_i=4O5,6VFN3,5HYUWV,RL3DJ,1https://www.gov.uk/government/publications/coronavirus-covid-19-hospital-discharge-service-requirementshttps://www.gov.uk/government/publications/coronavirus-covid-19-adult-social-care-action-plan/covid-19-our-action-plan-for-adult-social-carehttps://www.gov.uk/government/publications/coronavirus-covid-19-admission-and-care-of-people-in-care-homes

PPE is only effective when combined with good hand hygiene, goodrespiratory hygiene and effective infection control practice. Onlyapproved PPE should be worn. PPE is different to 'Face Coverings' - homemade fabric masks are notapproved for use at work as they are not fluid repellent.

Please note that this guidance is of a general nature, employers should consider the specific conditions ofeach individual place of work and comply with all applicable legislation, including the Health and Safety atWork etc. Act 1974 and should ALWAYS check the latest guidance at GOV.uk which is changing veryfrequently.

Correct use of Personal Protective Equipment [PPE] **

** Always check the latest guidance at GOV.UK for the latest PPE guidance;https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-care-homes https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-domiciliary-care

The risk of infection transmission increases when used PPE is handled (especially face masks). There is a safe way of applying and removing PPE. Please see videos at: here & https://youtu.be/-GncQ_ed-9w https://youtu.be/kKz_vNGsNhc

Putting PPE on & taking it off – Safe Practice

Emergency access to PPE supplies; To order emergency personal protective equipment providers can access the nationalportal to top up their existing supplies for COVID-19 in an emergency - guidance canbe accessed here. Call the customer service team on 0800 876 6802 if you have anyquestions about using the PPE portal. The team is available from 7am to 7pm, 7 days aweek, to help resolve your queries.Alternatively, If you cannot get the PPE you need through wholesaler routes or thePPE portal Nottinghamshire County Council will be using a new system for handingrequests for PPE. This web based system will enable you to request PPE, access yourprevious orders and view Public Health guidance. Please contact ppe@nottscc.gov.uk ifyou wouold like more information about this offer.

The correct use of appropriate PPE is essentialeven if you do not have any Covid-19 positive cases at your service. We remain in a period of sustained transmission - all preventative measures are vital to control risk & spread of the virus.

https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-care-homes/covid-19-putting-on-and-removing-ppe-a-guide-for-care-homes-videohttps://youtu.be/-GncQ_ed-9whttps://youtu.be/kKz_vNGsNhchttps://www.gov.uk/guidance/ppe-portal-how-to-order-emergency-personal-protective-equipment#when-to-use-local-resilience-forums

Avoid touching your faceAll waste should be disposed of into the waste bin in the residents room as all waste produced in theroom is classed as infectious. Orange infectious waste bags should be used ideally. If not available yellow clinical waste bags orblack household waste bags (in a home care setting) can be used but should be set aside for 72 hours,alternatively full waste bags should be double bagged and put into an external bin that is kept locked atall times.Laundry – use usual detergents, wash infected [suspected or confirmed] items separately from otherslaundry using a soluble linen  bag see guidance here Increase general cleaning. It is estimated that viable virus could be present for up to 5 days but less soon soft furnishings. Ensuring that areas are kept as clutter free as possible will aid effective surfacecleansing. Items such as magazines should be single person use only.Clean and disinfect regularly touched objects and surfaces using your regular cleaning products toreduce the risk of passing the infection on to other people.*

*Method: 1. detergent and water followed by a bleach based product diluted to a strength of 1000ppm, ensuring the correct contact times areadhered to 2. a combined detergent and sodium hypochlorite product diluted to a strength of 1000ppm, ensuring the correct contact times areadhered to.

Infection Prevention and Control

Before you come to workDo not come into work if you have symptoms. If you are symptomatic or have had a positive test resultyou must now self isolate for 10 days. See the guidance hereIf  using a car to get to work – use antibacterial spray/wipes for high risk areas before and after travel Come to work in clean clothes with a clean uniform to change into and a separate outer coat/clothes andwork shoes OR Come to work in a clean uniform and bring a clean change of clothes for the end of shiftin a clean disposable bag. Bring disposable bag to store uniform at the end of the shiftUse hand sanitiser 70% alcohol when you leave your vehicle

On arrival at your baseCheck your temperature, only commence work if your temperature is OK  Wash your hands for at least 20 seconds using soap and water, use disposable towels to dry yourhands well. Social distancing must be maintained during break times and on getting to and from work.

At the end of your shiftAppropriate use of PPE may protect clothes from contamination, but staff should change out of workclothes before travelling home. Work clothes should be washed separately, in accordance with themanufacturer’s instructions.Remove uniform and place in disposable bag to take home or use the care home laundry service Wash hands before leavingIf you are unable to change before leaving your place of work ensure your uniform is covered by anouter coat

On arrival homeIf you used your own car  before entering home disinfect the vehicle thoroughly e.g. seat belts and allfixtures inside and outside the car that have been touched Place all clothes or uniform straight into the washing machine and wash at the highest temperature forthe material Wash hands then shower/bath

Before leaving homeOn arrival at workWhen removing PPE in between caring for each residents When changing PPE for different personal care tasks withthe same residentAfter using the toiletAfter breaks and activitiesBefore food preparationBefore eating any food, including snacksBefore leaving workOn arrival at homeHand sanitiser is effective when it contains 70% alcohol orwhere it states virucidal effective

Wash your hands before, during and after allcontact with individuals for a minimum of 20seconds using soap and water. You must wash youhands:

Hand washing is key!

Hand washing technique guidance is accessible here https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/

General infection prevention and control principles

Infection Prevention and Control advice is available 24 hours a day If you need urgent IPC advice at any time or to report an outbreak please contact Public Health Englandon 0344 2254524.You can contact your LA/CCG for practical support about what to do next/how to manage, support withrisk assessment etc. Email the IPC teams: Nottinghamshire County - MACCG.IPC@nhs.net orNottingham City ncp.ipct@nhs.net and they will call you back in office hours.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/527545/Social_care.pdfhttps://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-extension-of-self-isolation-period-30-july-2020https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/

the ability to put in place practical measures to mitigate any risks.the ability and effectiveness to adhere to social distancing, including through visits in communalgardens and ‘window visits’.the possibility of using a designated visiting room, used by one resident and their visitor at a time,which is subject to regular enhanced cleaning such as a conservatory'In room' visits for essential reasons such as end of life care should remain in placethe health and wellbeing risks arising from the needs of the cohort, for example people withdementia or a learning disability becoming distressed with restrictions on visits, and if theserestrictions are lifted and then re-imposed.whether it is possible or practical to have different rules for different residents or cohorts.whether any residents, staff or visitors are in the extremely clinically vulnerable group.

Visits should be limited to a single constant visitor per resident wherever possibleSettings should collect Test and Trace information for residents, staff and visitors including previousstaff or agency staff and visitors. Information must include there names, addresses and telephonenumbers along with dates of visiting or working within the home.Documentation should:Make clear the decision-making process, including where there are different policies for differentgroups of residentsHighlight the potential risk of needing to rapidly re-impose visiting restrictions in case of an outbreakExplain that the frequency of visits will be controlled, and visitors should book an appointmentProvide advice for visitors, including relating to the potential impact of lockdown on the condition ofthe person they are visiting.Copies of visitor guidance, procedures and protocols should be available to visitors.Staff should be consulted on any anxieties and given appropriate support.If care homes intend to take a individual approach to a specific resident, it should engage with theresident’s family or other likely visitors, any ‘residents and relatives’ committee, and the residentthemselves where possible.

The Care Provider Alliance has published a sector-led protocol for enabling visiting including ideason different types of visits.

Care homes should consider:

 Key policies and procedures for care homes:

1.

2.3.4.

Some people with dementia and learning disabilities may lack the relevant capacity to decide whetheror not to consent to a provider’s visiting policy. These residents will fall under the empoweringframework of the Mental Capacity Act 2005 (MCA) and are protected by its safeguards.

The Directors of Public Health for Nottingham City and Nottinghamshire County are advising that carehomes can allow visitors, once they have completed a risk assessment (24th July 2020). This does not apply to care homes with active outbreaks, which should remain closed to visitors until theoutbreak is declared ‘over’ by your local IPC team.

The situation is constantly changing. This may result in the need to rapidly re-impose visiting restrictionsin all, or individual care homes in case of a care home outbreak; a large, local workplace outbreak; or a risein cases in the neighbouring community as part of local outbreak planning Directors of Public Health will contact care homes if their advice changes for all or individual care homes andupdate this toolkit page as appropriate.

Updated government guidance on visiting arrangements to care homes was published for care homeproviders and Directors of Public Health on 22nd July 2020. Below is a summary but please read theguidance in full here.

Directors of Public Health, as well as guidance from the local infection-control leads from the Clinical Commissioning Group (CCG), and local Public Health England (PHE) Health Protection Team (HPT).

The decision on whether or not to allow visitors, and in what circumstances should be made by providersand managers of each individual setting.

However Care Homes should base their decision on allowing visits on the advice from:

Visitors to care home settings

When was the guidance published and who is it for?

Who makes the decision on opening to visitors?

What are the Directors of Public Health saying?

What does the guidance say?:

https://careprovideralliance.org.uk/coronavirus-visitors-protocolhttps://careprovideralliance.org.uk/coronavirus-visitors-protocolhttps://www.gov.uk/government/publications/visiting-care-homes-during-coronavirus/update-on-policies-for-visiting-arrangements-in-care-homes

Facilities should be provided for hand-washing.Areas used by visitors will need to be decontaminated several times throughout the day and must befree of clutter to aid cleaning. Visitors should be supported to wear a face covering and shown how to decontaminate hands prior toapplying and removing the face covering. If providing care then PPE should be worn to the same level asa care worker would wear. It is recommended that bookings or appointments for visitors are put in placerather than having an ‘open house’ informal visiting system.Visitors should have no contact with other residents and minimal contact with care home staff (less than15 minutes / 2 metres).All visitors should be screened for symptoms of acute respiratory infection before entering. Specificscreening questions are detailed in the full guidance.Visiting procedures should include arrangements for regular attenders e.g hairdresser, activitycoordinator and their safe working arrangementsVisitors should be encouraged to walk to the home or use their own transport.Visitors should be encouraged to keep physical interaction with the resident to a minimum.If gifts are permitted, these will need to be easy for the care home to clean to prevent crosscontamination.

If you have queries related to infection prevention control procedures for visitors then please contactyour local IPC team. Email the IPC teams: Nottinghamshire County - MACCG.IPC@nhs.net or  Nottingham Cityncp.ipct@nhs.net and they will call you back in office hours or PHE out of hours tel 03442254524

Queries related to the advice of the Director’s of Public Health can be addressed to NottinghamshireCounty Council (Coronavirusph@nottscc.gov.uk or Nottingham City Council(coronavirusqueries@nottinghamcity.gov.uk).

The care home is currently closed with an outbreakThe individual being visited has Covid-19 unless agreed by the manager (Usually EOL)If the visitor has recently returned from oversees travel (within the past 14 days)If the visitor has had contact with anyone known to have Covid-19 in the past 14 daysHas ANY of the symptoms associated with Covid-19 (new self isolation guidance in place)Is under the age of 16 (unless in special circumstances as agreed by the manager)Has not made prior arrangements with the staff/individual to enable planning of the visit

Visitors to care home settings continued

What do Care Home need to put in place prior to visits?

What face coverings/PPE should visitors wear?Visitors to care homes should wear a form of face covering (e.g. cloth mask that they are instructed tocome with) whenever they are in the care home. Visitors who provide care during their visit should wear appropriate PPE.

Who can I contact if I have questions?

Visitors should not attend if...

https://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-extension-of-self-isolation-period-30-july-2020

Call 0300 300 3000 – Testing Coordination CentreConfirm your staff and resident numbersThe Testing Coordination Centre will access the digital portal and book swabs for your homeYou will be offered infection prevention and control support immediatelyYou will be offered support from the Care Home Swabbing team, who will/can attend your home andoffer assisted swabbing for residents, support staff swabbing & train staff in swabbing for future needsWhen your swabs are completed, your swabs will be picked up by the National Testing Programmecourier from your home, and will be transited to the Pathology labThe Care Home Manager will receive the test outcomes directly within 72 hours, and mustcommunicate these to the Testing Coordination CentreIf the test results include a positive, you must inform the GP and PHE, the Infection Prevention &Control teams, alongside the Enhanced Care Home Support teams, will mobilise immediately toprovide you with an increased support offer

If you are a Care Home Manager and you have a symptomatic resident please follow the processbelow:

Covid-19 Testing/swabbing Nottingham and Nottinghamshire

What to do if you have a suspected positive COVID-19 resident

Regular retesting for care home staff and residents

Nottingham and Nottinghamshire Testing Coordination Centre:Coordination Centre open 8am to 6pm on 0300 300 3000.Email - nnccg.Covid19-testingcell@nhs.net 

How will testing/swabbing work in Nottingham and Nottinghamshire?

The Local Resilience Forum (LRF) Testing Cell, in collaboration with the Care Home Cell, has developeda supportive approach for Care HomesThis ensures we can facilitate local co-ordination support throughout the whole testing process, whilstflexing to accommodate the national policy guidance

The planned local approach to the coordination of care home testing is set out below;

The approach is underpinned by the need bring clarity for care homes on;- routes to testing - support for testing - follow up supportFor all enquiries or support, please contact;

Voids/Rejected swabs

It is expected that all care homes will have additional swabs to their needs. Surplus swabs can be used to re-swab residents where a void swab has been issued.It is essential that a courier is booked to collect the swabs prior to taking the swab.Courier details will be supplied to you on initial collection- please contac t the same courier to collectvoids. 

Staffing support offer -How to access a Relief Workforce The email address you will use is sfh-tr.temporary.staffingoffice@nhs.net to request emergency staffing aminimum of 24 hours before shift cover is required. You will need to provide the following details: Name of care home Date of shift Day or night shift (SFH will supply 12 hour shifts only) Type of staff (carer or trained nurse) Proof of indemnity cover e.g. a scan of level of insurance cover and dates Name of the manager and confirmation they will pay the invoice within 30 days

Antibody testing is available to all social care staff for a period of 10 weeks starting on Monday 10th

August. Clinics will be running across the county at various time during this period. If you would like

to check local availability and book a test please call 0300 300 3000 between 9am and 5pm Monday

to Friday. Please remember a positive antibody test does not convey immunity and all safe practices

must continue.

Antibody Testing

Care home staff can be tested every week and residents monthly to identify anyone with thevirus and reduce transmission. Repeat testing will be initially prioritised for care homesprimarily looking after over 65s or those with dementia before being rolled out to all adultcare homes.The government’s Vivaldi 1 care home study highlights the importance of regular stafftesting while there is a higher prevalence in care homes. An information fact sheet can beaccessed here.

Care homes should register for retesting here https://www.gov.uk/apply-coronavirus-test-carehome, as soon as possible. Note even if you previously registered for whole hometesting when it was first made available, you will need to re-register on the portal in order toreceive regular retesting.

How to carry out testing on staff and residents can be found here - Staff & Residents.For more information on whole home testing click here.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/906092/Care_home_testing_factsheet_accessible.https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/906092/Care_home_testing_factsheet_accessible.https://www.gov.uk/apply-coronavirus-test-carehomehttps://www.youtube.com/watch?v=8lo6g-TYZ-c&https://www.youtube.com/watch?v=1l0jcv37WzI&feature=youtu.behttps://www.gov.uk/guidance/coronavirus-covid-19-getting-tested#care-home

I was wearing PPE:

I was not wearing PPE or had a PPE breach:

I was wearing PPE whilst the contact was made and/or we have been maintaining socialdistancing (including on breaks): it is unlikely to be considered a ‘close contact’ and the staffmember can return to work.

I was not wearing PPE whilst the contact was made and social distancing was not followed: ifcontact was close or made for over 15 minutes when masks were removed and social distancingwas not applied, then it is likely that this would be considered a ‘close contact’ and self-isolationguidance would apply.

There are two exceptions to this guidance that apply to health and social care staff.

NHS test and trace work to identify the close contacts of a person who tests positive; where positiveresults involve those working in a health or social care setting, the NHS test and trace service mayrefer the case to Public Health England (PHE) who then provide guidance to the health or social caresetting.

1. What if I have had close contact with a resident /service user who has tested positive forCOVID-19?

If a staff member has been caring for a Covid-19 positive resident/service user and appropriate PPEhas been worn, this contact will need to be risk assessed by the managerwith advice from PHE. This is unlikely to be considered a ‘close contact’ and the staff member canreturn to work.

If a staff member has been caring for a Covid-19 resident/service user and they were not wearingPPE or there was a breach in PPE this contact will need to be assessed by the manager with advicefrom PHE. It is likely that this would be considered a  ‘close contact’ and self- isolation guidancewould apply.

2. What if I have had close contact with a colleague at work who has tested positive forCOVID-19?

If a staff member has had close contact at work with a co-member who has been confirmed Covid-19positive, this contact will need to be risk assessed by the manager with guidance from PHE. 

Test and Trace The NHS test and trace service helps trace close recent contacts ofanyone who tests positive for Covid-19 and if necessary, notifies them thatthey must self-isolate at home to help stop the spread of the virus.

Care home and homecare workers should follow the same advice as the general public apart from the exceptionsnoted on the right. Anyone who has had close contact with someone who tests positive for Covid-19 will beexpected to isolate themselves for 14 days, or for 10 days from developing symptoms of Covid-19. See guidancehere

The PHE Health Protection team can be contacted on 0344 225 4524.

‘Close contact’ occurs in a number of circumstances including:• When you have skin-to-skin physical contact with someone with confirmed covid-19• When you have face-to-face contact within one metre of someone with confirmed covid-19 e.g. face to face conversation• When you are within one metre of someone with confirmed covid-19 for one minute or longer without face-to-face contact• When you spend more than 15 minutes within two metres of someone with confirmed covid-19• When you have cleaned a personal or communal area of the home of someone with confirmed covid-19, the first time the cleaning occurs

https://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-extension-of-self-isolation-period-30-july-2020

How can I best protect myself and my colleagues while at work?

• Social distancing: to help minimise future staffing concerns please ensure that in any instance where the use of PPE is not required,for example during a break, strict social distancing measures are applied so that staff remain 2 metres apart. If this is not possible thenconsider staggered break times to reduce close contacts with others wherever possible.

• Hand hygiene: hand hygiene is essential as it reduces the spread of infection. This must be performed before and after direct care,contact with others and frequently throughout the shift including after using the toilet, before eating, during breaks and after contactwith PPE or the environment.

• Appropriate use of PPE: ensure staff are not wearing fabric ‘homemade’ masks at work as these would be considered a breach inPPE use.

How to access the Relief Workforce – Process updatedThe email address you will use is sfh-tr.temporary.staffingoffice@nhs.net to request emergency staffing a minimum of 24 hours before shift cover is required.

You will need to provide the following details: Name of care home Date of shift Day or night shift (SFH will supply 12 hour shifts only) Type of staff (carer or trained nurse) Proof of indemnity cover e.g. a scan of level of insurance cover and dates Name of the manager and confirmation they will pay the invoice within 30 days

Management of exposed healthcare workers and patients in hospitalsettings Guidance for contacts of people with possible of confirmed Covid-19infection who do not live with the person Test and trace: how it works

Published guidance

What happens if, once risk assessed, I need to self-isolate as a contact? It is important that anyone identified as a close contact self-isolates.

Asymptomatic contacts may be offered a test for Covid-19 if there is aclinical need to do so. Clinical need would be agreed in partnership with PHEand the manager.

If the test is negative the 14-day self-isolation period muststill be completed. This is because you may have the virus,but it cannot be detected by a test yet.

If the test is positive then the staff member must self-isolateand may return to work after TEN days, providing they arewell and have not had a fever for 48 hours. If asymptomaticwhen tested but symptoms later appear (within the 10 days)the 10 day isolation will need to start over from day 1 ofsymptoms.

Staff and residents who have previously tested positive forCOVID-19 should be exempt from re-testing within a periodof 6 weeks unless they develop new symptoms, in whichcase they will need retesting. Those who are tested after 6weeks from their initial test or illness onset and are stillfound to be positive, this could be due to a persistentlypositive test associated with the original infection, ratherthan a new infection as the virus can remain for some timefollowing infection. If they have developed new possible after 6 weeks, they would need to isolate again.

Risk assessment for assessing a PPE breach is outlined within government guidance available in section 6 here.

Test and Trace Continued ....

Staffing Concerns following Test and Trace;

Social distancing must be maintainedduring break times and on getting to

and from work.

What does a breach in PPE mean?This may be non-approved PPE such as fabric masks, PPE that was damaged during use, or where there was a breach in PPE while providingpersonal care. Examples that are unlikely to be considered breaches include if a health or social care worker was not wearing gloves for ashort period of time or their glovestore, and they washed their hands immediately, or if their apron tore while caring for a resident/service user and this was replaced promptly.

https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settingshttps://www.gov.uk/government/publications/guidance-for-contacts-of-people-with-possible-or-confirmed-coronavirus-covid-19-infection-who-do-not-live-with-the-person/guidance-for-contacts-of-people-with-possible-or-confirmed-coronavirus-covid-19-infection-who-do-not-live-with-the-personhttps://www.gov.uk/guidance/nhs-test-and-trace-how-it-workshttps://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-extension-of-self-isolation-period-30-july-2020https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings

Assess twice daily for a high temperature (37.8°C or above), a cough and softer signs i.e. being short ofbreath, being not as alert, having a new onset of confusion, being off food, having reduced fluid intake,diarrhoea or vomiting.Where possible, care home staff should be trained to measure other vital signs including blood pressure,heart rate, pulse oximetry, respiratory rate level of consciousness and new confusion to monitor fordeterioration of ANY cause. Training videos can be found here A NEWS2 score will indicate an appropriate level and frequency of monitoring required as documentedin RESTORE2 booklets. If care staff feel that the person needs more frequent monitoring this iswelcomed, however the frequency of monitoring should never be less than recommended withinRESTORE2 guidelines.If temperature is 37.8 or more with or without a continuous cough the individual should be cared for as ifCOVID-19 positive. If oxygen levels have reduced by >2% below their normal, the individual should be cared for as COVID-19positive. Oxygen saturation monitoring devices are available via your CCG.Note that symptoms can be vague, it could be a general deterioration – a new fall, a headache etc. Allshould be treated as possible COVID and the resident isolated for 14 days and a request for testing made

As symptoms can often present atypically or vague any other signs of concern for additional support contact Call for Care – 01623 681691 or  Citycare Mon–Fri 8am-6pm - 0115 8834863. Weekend&Bank Holiday8am-6pm 0782782346. Evening and night service 0115 8838151 or 0115 8838152- for support/advice orcontact NHS 111 9 * 6

Where possible care staff should be trained to measure temperature,  blood pressure, heart rate, pulseoximetry, respiratory rate level of consciousness and new confusion to monitor for deterioration of ANYcause.Training videos for taking and recording temperature, pulse rate, blood pressure, oxygen saturations,respiration rate and conscious levels can be found here and can be accessed by family members orcarers.If temperature is 37.8 or more with or without a continuous cough the individual should be cared for as ifCovid-19 positive. If temperature is above 37.8 or more and  the individual is becoming newly confused, poor colour, raisedrespiratory rate and/or they have developed a continuous cough they should be cared for as if Covid-19.Deterioration tools are beneficial for use with those supported by Home Care. Our training team will workwith providers to implement RESTORE2Mini or the full RESTORE2 tool. Please contact empscdet@nottingham.ac.uk to arrange your free training.

RESTORE 2 can help you to spot deterioration from Covid-19 related illness or recognise non-Covid-19related deterioration and act to get your individual the most appropriate care and support. RESTORE2 uses three tools (Soft Signs, NEWS2 and SBARD) which when used together can help you toget the help and support you need more quickly. The CCG, Patient Safety Collaborative -Academic Health Science Network and Notts Alliance TrainingHub have joined together to work with you and your teams to help you to use this with your residents . If you would like to know more and access the fantastic resources, please contactempscdet@nottingham.ac.uk

Recognising and Responding to Deterioration

Home Care

Nursing and Residential Care Homes

During the 'weekly check in' please use the Restore/News2 scores to identify individuals you areconcerned about for assessment and care

For all potentialcorona virusinfections seekmedical advice earlyas symptoms canoften presentatypically or vague.

Assess the appropriateness of admissionto hospitalEnsure the respect document is up todate and complete Ensure GP/Ambulance Crew hospital orcall handler is aware of the status whenescalating - confirmed or suspected. Always refer to the individuals’advance care plan/Respect form toconsider the right course of action inan emergency

Appropriate Escalation!

https://www.youtube.com/playlist?list=PLrVQaAxyJE3cJ1fB9K2poc9pXn7b9WcQghttps://www.youtube.com/playlist?list=PLrVQaAxyJE3cJ1fB9K2poc9pXn7b9WcQg

Nottinghamshire Area Prescribing Committee (NAPC) host a collaborative strategy forensuring consistent high quality and cost effective use of medicines acrossNottinghamshire.The NAPC website is the ‘go to‘ place for medication guidance and supporthttps://www.nottsapc.nhs.uk/covid-19/ and is updated frequently with new and updatedguidance in a variety of settings including care homes.  Please  refer to our most recent prescribing guideline for End of Life care for Covidpatients.

Bi monthly newsletter is produced jointly with local authority colleagues and contains a range ofinformation for both care homes and home care providers. If you don’t currently receive this but wouldlike to be added to our mailing list please email lisa.ryley@nhs.net

The document  “Guidance on medicines in social care establishments “  provides care homes with lotsof information on medicines management issues.All care home staff who manage medications should be familiar with this local document.  The guidance is currently under review so that it will apply to care homes across both local authorities.Please contact lisa.ryley@nhs.net for a copy.

The British Geriatric Society published best practice guidance for managing the Covid-19 pandemic incare homes The guidance makes 22 key recommendations including palliative and supportive considerationsIt can be accessed here and at https://www.bgs.org.uk/resources/covid-19-managing-the-covid-19-pandemic-in-care-homes

In response to Covid-19 the government has recently launched a medicines re-use scheme. Some types of medication can be re-used for others with the same prescription even though it was notoriginally dispensed for that individual. The CCG has produced a local guidance document that homes may wish to use to implement thisscheme. For a copy please email Tania Cook taniacook@nhs.net

Care about Medicines newsletter

Guidance on Medicines in Social Care Settings

British Geriatric Society, Best practice Guidance – Care Homes and Covid-19

Medication re-use scheme

The CCG has a  number of pharmacists and technicians who can support both care home  and homecare providers with a range  of areas including medication reviews and ordering processes.Please email taniacook@nhs.net   or cosborn@nhs.net

Questions/Queries? If you have ANY Medication Management queries, please contact our Nottingham and NottinghamshireMedication Management teams via email at  MACCG.NottsAPC@nhs.net (office hours only).

Excellent free training resources have been bought from PrescQIPP, a NICE and skills for care accredited provider of medicines management training. There are separate packages, one forcare homes and one for home care providers. The links below explain how to access thetraining: For home care providers;https://www.prescqipp.info/media/4743/prescqipp_managing_medicines_for_adults_receiving_social_care _in_the_community_e_learning_course_overview.pdf For care homes; Visit the prescQIPP e-learning platform - https://moodle.prescqipp.info/login/index.php For more information or you are experiencing issues registering please contact Tania Cooktaniacook@nhs.net

Controlling symptoms of Covid-19 in Community Settings & NICE Clinical Guidance NG163offer guidance about how to mange Covid-19 treatments and care planning. https://www.nice.org.uk/guidance/ng163 https://www.nottsapc.nhs.uk/covid-19/

Access to free medicines management trainingfor care providers

Medications and Symptom Management

Symptom Management

Nottinghamshire Area Prescribing Committee

Medications management resources

Medicines Optimisation Support

https://www.nottsapc.nhs.uk/covid-19/https://www.nottsapc.nhs.uk/covid-19/https://www.bgs.org.uk/resources/covid-19-managing-the-covid-19-pandemic-in-care-homeshttps://www.bgs.org.uk/resources/covid-19-managing-the-covid-19-pandemic-in-care-homeshttps://www.prescqipp.info/media/4743/prescqipp_managing_medicines_for_adults_receiving_social_care%20_in_the_community_e_learning_course_overview.pdfhttps://www.prescqipp.info/media/4743/prescqipp_managing_medicines_for_adults_receiving_social_care%20_in_the_community_e_learning_course_overview.pdfhttps://www.prescqipp.info/media/4743/prescqipp_managing_medicines_for_adults_receiving_social_care%20_in_the_community_e_learning_course_overview.pdfhttps://moodle.prescqipp.info/login/index.phphttps://moodle.prescqipp.info/login/index.phphttps://moodle.prescqipp.info/login/index.phphttps://moodle.prescqipp.info/login/index.phphttps://www.nice.org.uk/guidance/ng163https://www.nice.org.uk/guidance/ng163https://www.nottsapc.nhs.uk/covid-19/

The ReSPECT document supports people to get theright level of care and support at the end of their lives. · It is one of the ways they or their loved ones can be incontrol at the end. · ALL individuals should be offered an advance careconversation with relatives if necessary or desiredleading to the creation of a ReSPECT Form to recordtheir priorities and escalation plans. · Please ensure, where appropriate, all individuals areoffered the opportunity to have an advance care plan inplace. · If the individual does not have an advance care planyou can discuss this with your nurses or GP. · ANYONE (qualified and unqualified staff] can start aReSPECT form but it will need to be signed by a GP orSenior Nurse. · ReSPECT forms can be signed at weekly MDT meetings.https://www.resus.org.uk/respect/learning/   https://learning.respectprocess.org.uk/#landing

The Mental Capacity Act and Covid-19 The Mental Capacity Act (MCA) provides protection and upholds the rights ofpeople who lack, or may lack, capacity to make decisions about different aspects oftheir life. It is important to remember that the principles of the MCA and theDeprivation of Liberty Safeguards (DoLS) have not been changed as a result of thepandemic.You may be faced by unfamiliar situations and decisions, for example,assessing a person’s capacity to be tested for Covid-19 or where public healthrestrictions interface with the MCA. The Government has issued updated guidanceon the Mental Capacity Act and Covid-19 - https://www.gov.uk/government/publications/coronavirus-covid-19-looking-after-people-who-lack-mental-capacity. This guidance is to help address these issuesand support you in ensuring the rights of the people you, in turn, support.

Some individuals experience severesymptoms and a rapid decline. Earlymanagement of symptoms can alleviateany suffering and it is important to delivereffective medications in effective doses from the outset.https://www.nice.org.uk/guidance/ng163

End of Life care and management

It is good practice to ensure all residents are proactively assignedan accurate RAG status. In the context of Covid-19 transition from amber to red and deathmay be a few days -hours only.ALL amber & red  should be known to a health care professionalfor registration on EPaCCS - Electronic Palliative Care CoordinationSystems to enable coordinated care and support.

https://www.goldstandardsframework.org.uk/gsf-signposting-and-guidance-on-the-coronavirus-epidemic

Symptom Management You can use technology to getadvice from the GP and holdmultidisciplinary meetings tosupport end of life care. You canuse your personal devices ifnecessary. If possible have thevideo consultation in theindividual’s room or somewhereprivate. This approach can also beuse after death for verification

https://nottinghamshire.eolcare.uk/ - Notts EOL Website

Virtual Assessment

Sign up for NHS Mail soMicrosoft Teams can beused for videoconsultations. Contact Kaleidoscopeconsultants for support -dspt@notts-care-ig.netor https://notts-care-ig.net

Someone approaching the end of their lifeneed to feel they are most importantperson in the world—you can ease thepassage of dying and enable them to have adignified and peaceful experience

Use ReSPECT and Advance Care Plans asthey describe what matters to theresident; family, friends, theenvironment and demonstrate that you understand what is important to them. You can also monitor that they are painfree and peaceful, whilst supporting theirloved ones

Just Breathe!

Advance Care Plan

It's about dying well

Change the pace - your time isthe greatest gift you can give

Gold Standards Framework

One Chance to

get it Right

https://www.gov.uk/government/publications/coronavirus-covid-19-looking-after-people-who-lack-mental-capacity/the-mental-capacity-act-2005-mca-and-deprivation-of-liberty-safeguards-dols-during-the-coronavirus-covid-19-pandemichttps://www.gov.uk/government/publications/coronavirus-covid-19-looking-after-people-who-lack-mental-capacity/the-mental-capacity-act-2005-mca-and-deprivation-of-liberty-safeguards-dols-during-the-coronavirus-covid-19-pandemichttps://www.nice.org.uk/guidance/ng163https://www.goldstandardsframework.org.uk/gsf-signposting-and-guidance-on-the-coronavirus-epidemichttps://nottinghamshire.eolcare.uk/

Confirmation or verification of death is defined as deciding whether a person is actually deceased.Verification of death can be undertaken by staff who are competent and confident  to carry out thistask. Your organisation/service should have a policy/procedure which will support you to undertake thispractice. You should be familiar with this.

Call for care – 01623 681691 or Nottingham Citycare 0115 8834863 (Monday – Friday 8am-6pm) 0115 8838151 or 0115 8838152(Evening and night service) 0782782346 weekends and Bank Holiday 8am-6pm

In Nottingham and Nottinghamshire local guidance – ‘Death administration in the community’ is available,staff should be familiar with this as it supports Verification of expected death practice. It also includes apre authorisation template which will support staff and partners in decision making when verification ofdeath is needed

If you do not have a competent/trained person available  to verify death contact:

The person registering a death (known as the informant) can be: •a close relative of the deceased, named the executor of the Will. •a relative who witnessed the loved one’s death, last illness or who lives near their residence•the owner of the premises where the death occurred•the relative arranging the funeral with the funeral director or someone else who was present at thedeath

During the Covid-19 pandemic doctors are emailing death certificates directly to the Registrars (so noneed for relatives to pick up from surgery)

When a person dies of suspected coronavirus (Covid-19) in a residential care setting be aware that thereis likely to be continuing risk of infection from body fluids. Whilst undertaking last offices, it isrecommended that the usual PPE and standards of Infection prevention control precautions aremaintained. You should follow the usual processes for dealing with a death in your setting.Since there is a small but real risk of transmission from the body of the deceased, mourners should beadvised not take part in any rituals or practices that bring them into close contact with the body of anindividual who has died from, or with symptoms of Covid-19. Given the very significant risk for vulnerableand extremely vulnerable people who come into contact with the virus, it is strongly advised that theyhave no contact with the body. Cremation is permitted where the deceased does not have a medicaldevice that requires removal e.g. pacemaker/ICD.

Informing the CQCThe CQC are now recording all deaths where Covid-19 was possible or confirmed Please inform the CQCusing your usual notification form even if the person dies in hospital

Published Guidancehttps://www.gov.uk/government/publications/covid-19-guidance-for-care-of-the-deceased/guidance-for-care-of-the-deceased-with-suspected-or-confirmed-coronavirus-covid-19 https://www.gov.uk/government/publications/covid-19-guidance-for-care-of-the-deceased https://www.hse.gov.uk/pubns/books/hsg283.htm

A grief line has been set up to support staff and families indealing with emotional distress related to loss of loved ones. The grief line will listen and offer practical support whereneeded as well as signposting to existing grief support.

You can call 0800 111 445   8am til 5pm Monday - Friday. If you require urgent grief support, you will be provided with annumber to contact outside of these hours.

Death Verification

Confirmation or Verification of Death

Death certificationAll doctors in primary care AND hospitals NUH, NHCT, SFHFT can carry out death certification. Where anindividual  has been discharged from hospital and dies quickly before any contact with GP, the hospitaldischarging doctor should be asked to complete the death certificate. Doctors can do the deathcertification if they have seen the Individual within 28 days (this can be by video which you are asked tohelp facilitate) or after death.

Death Registration

Care of the deceased - after care

Grief & Bereavement Support

Care staff do this informally already, they absolutely know when their loved one's have passed away, if the death was expected, they shouldn't have to wait for others

to tell them what they already know.

https://www.gov.uk/government/publications/covid-19-guidance-for-care-of-the-deceased/guidance-for-care-of-the-deceased-with-suspected-or-confirmed-coronavirus-covid-19https://www.gov.uk/government/publications/covid-19-guidance-for-care-of-the-deceasedhttps://www.hse.gov.uk/pubns/books/hsg283.htm

Public Health

T: 0344 225 4524Email:phe.crc.eastmidlands@nhs.net

Infection Prevention& Control

County Email:MACCG.IPC@nhs.netCity Email: ncp.ipct@nhs.net

Testing/swabbingTeam

T: 0300 300 3000Email: nnccg.Covid19-testingcell@nhs.net

Enhanced CareResponse Team

(ECRT)

Click link below

sfh-tr.ecrt-midnotts-icp@nhs.net

CCG Quality Assurance Email:nnestccg.southnottspatientsafety@nhs.net

Quality Improvement(EHCH)Email: d.nussey@nhs.net

Recognising andResponding toDeterioration

Email:empscdet@nottingham.ac.ukEmail: michele.tuttle@nhs.net

MedicationsManagement Team

https://www.nottsapc.nhs.uk/covid-19/

Email: taniacook@nhs.netEm,ail: lisa.ryley@nhs.netEmail: MACCG.NottsAPC@nhs.net

Grief Line

Gov.ukClick link below

https://www.gov.uk/coronavirus

Notts Alliance TrainingHub/Workforce support

alliance.hub1@nhs.net

Click link below

https://www.nottstraininghub.nhs.uk/

Local AuthorityQuality and MarketManagement Teams

County - Email:qmm@nottscc.gov.ukCity - Email:CV19@nottinghamcity.gov.uk

Nottingham CityWebsite - Ask Lion

Click link below

www.asklion.co.uk/providercornercovid-19

Notts Help Yourself

Click link below

https://www.nottshelpyourself.org.uk/kb5/nottinghamshire/directory/document.page?id=Igc3gkzdlkc

Notts EOL web site

Click link below

https://nottinghamshire.eolcare.uk/

Care Forum 'We are all in this

together'

Click link below

https://us02web.zoom.us/webinar/register/WN_CNjl

JyX-Sf6t_sugpWd5vg

WhatsApp GroupCovid-19 Care Group

https://webapp.mobileappco.org/m/COVID19CARE/?

appcode=COVID19CARE

Essential Contacts

0800 111 445

https://www.nottsapc.nhs.uk/covid-19-faqs/https://www.asklion.co.uk/kb5/nottingham/directory/advice.page?id=HROxySzKqXohttps://us02web.zoom.us/webinar/register/WN_CNjlJyX-Sf6t_sugpWd5vg

Public Health

T: 0344 225 4524Email:phe.crc.eastmidlands@nhs.net

Infection Prevention& Control

County Email:MACCG.IPC@nhs.netCity Email: ncp.ipct@nhs.net

Testing/swabbingTeam

T: 0300 300 3000Email: nnccg.Covid19-testingcell@nhs.net

Enhanced CareResponse Team

(ECRT)

Click link below

sfh-tr.ecrt-midnotts-icp@nhs.net

CCG Quality Assurance Email:nnestccg.southnottspatientsafety@nhs.net

Quality Improvement(EHCH)Email: d.nussey@nhs.net

Recognising andResponding toDeterioration

Email:empscdet@nottingham.ac.ukEmail: michele.tuttle@nhs.net

MedicationsManagement Team

https://www.nottsapc.nhs.uk/covid-19/

Email: taniacook@nhs.netEm,ail: lisa.ryley@nhs.netEmail: MACCG.NottsAPC@nhs.net

Grief Line

Gov.ukClick link below

https://www.gov.uk/coronavirus

Notts Alliance TrainingHub/Workforce support

alliance.hub1@nhs.net

Click link below

https://www.nottstraininghub.nhs.uk/

Local AuthorityQuality and MarketManagement Teams

County - Email:qmm@nottscc.gov.ukCity - Email:CV19@nottinghamcity.gov.uk

Nottingham CityWebsite - Ask Lion

Click link below

www.asklion.co.uk/providercornercovid-19

Notts Help Yourself

Click link below

https://www.nottshelpyourself.org.uk/kb5/nottinghamshire/directory/document.page?id=Igc3gkzdlkc

Notts EOL web site

Click link below

https://nottinghamshire.eolcare.uk/

Care Forum 'We are all in this

together'

Click link below

https://us02web.zoom.us/webinar/register/WN_CNjl

JyX-Sf6t_sugpWd5vg

WhatsApp GroupCovid-19 Care Group

https://webapp.mobileappco.org/m/COVID19CARE/?

appcode=COVID19CARE

Essential Contacts

0800 111 445

https://www.nottsapc.nhs.uk/covid-19-faqs/https://www.asklion.co.uk/kb5/nottingham/directory/advice.page?id=HROxySzKqXohttps://us02web.zoom.us/webinar/register/WN_CNjlJyX-Sf6t_sugpWd5vg

City Care Homes Team City care (city care homes only) can be contacted;Monday – Friday 8am-6pm - 0115 8834863  Weekend and Bank Holidays -  8am-6pm – 07827823465  Between 6pm and 8am everyday – Evening and night service 0115 8838151 or 0115 8838152

Nottingham & Nottinghamshire System Support pathways

Offers care home and home care staff a direct line to a clinician who will be able to discuss any concerns you have for an individual in your care. The 9 *6 option bypasses the call handler algorithm to enable a less formalconversation. It is very helpful to NHS 111 9* 6 clinicians if you use SBARD to communicate theconcern and have and all basic information to hand such as the persons date ofbirth, address, postcode, medications etc. If you are concerned about an individual you can contact NHS111 9 *6.

NHS 111 - 9 * 6

 

Call for Care Call for Care Tel: 01623 781899 (Mid Notts) Option 1 - Admission avoidance (2 hour response) Option 2 - End of Life and Palliative Care Option 3 - Planned Care (non-urgent referrals for all general health services) Call for Care Tel: 0300 0830 100 (South Notts)  Option 1

NottinghamshireHealth Care Trust A-Z

of services

Nottingham City Care A-Z of services

Click link below

https://www.nottinghamshirehealthcare.nhs.uk/a

-z-of-services

Click link below

https://www.nottinghamcitycare.nhs.uk/find-a-

service/

https://www.nottinghamshirehealthcare.nhs.uk/a-z-of-serviceshttps://www.nottinghamcitycare.nhs.uk/find-a-service/

This toolkit has been created to be used as an aide memoire/quick reference guide forcare home and home care staff managing Covid-19. This guidance is not mandatory – its purpose is to support staff to deliver high qualitycare for individuals by bringing together best practice guidance and references to keydocuments to support practice all in one place. This guide has been co-developed by Nottingham and Nottinghamshire Integrated CareSystem with contributions from;Nottingham and Nottinghamshire CCGsNottinghamshire HealthCare Trust Nottingham City Care Nottinghamshire EOL Stakeholder Board Nottinghamshire GPs Nottingham University HospitalsNottingham City CouncilNottingham County CouncilSherwood Forest HospitalsICS Clinical Leads Care home and Home care providers Nottingham City and County LA Public Health Colleagues

This guidance was produced in response to the Covid-19 Pandemic. In this fast paced,continuously developing and changing situation, it is expected that best practiceguidance will be updated frequently.

A good practice tip would be to keep an electronic file with this guidance and all thelatest attachments for each of the focus areas available to staff to use as a referenceguide to support Covid-19 EOL care and management. This is a working document and further updates and co-design with sector experts willbe made as required.

Quality ControlThe information provided within the toolkit will be reviewed and updated daily duringthe Covid-19 pandemic.

Information from reputable sources will include (but not limited to); Gov.uk. PatientSafety Collaborative/Academic Health Science networks. UK Resuscitation Council.Nottinghamshire Area Prescribing Committee. Public Health England and Local IPCteams. NHSE/I. ADASS. CQC. Local Authorities and TeamNet

The latest version will be shared as a minimum, weekly and will be version controlledwith the latest date e.g V.280420. 

The content may change to reflect the fluid position of today and the future.

Points of clarification/additional information queries should be directed to  Nottingham& Nottinghamshire CCG - nnestccg.southnottspatientsafety@nhs.net