COVID-19 - QCS...Apr 03, 2020 · supervision agenda Check the understanding of the person...
58
COVID-19 The Complete Winter Planning Toolkit
Transcript of COVID-19 - QCS...Apr 03, 2020 · supervision agenda Check the understanding of the person...
2
t: 0333 405 3333 w: www.qcs.co.uk
Table of Contents
COVIDREADY#HereToCare
Leadership
Hospital Discharge
Communication
Quality of Life
Flu Guidance for Care Homes2020-2021 Staff Influenza Vaccine Declination FormLeadership & How to Prepare for & ‘Thrive’ During Likely Challenges Experienced During Winter 2020 - Checklist
COVID-19 Admission and Discharge Actions for Care Home ResidentsEnsuring a Safe Hospital Discharge Checklist- A Communication Tool
Communication AuditCommunicating with External Partners Staff Communication AuditResidents, Relatives & Advocates Audit External Communication Audit
Supporting People to Stay ConnectedRecognising Loneliness, Social Isolation, or WithdrawalScreening Checklist for Social Isolation-WithdrawalCOVID-19 Delirium Fact SheetRehabilitation Post COVID-19 Care Plan TemplateGuidance on Managing Post COVID-19 Recovery
3
47
10
20
2123
282932343638
40
414450525456
4
t: 0333 405 3333 w: www.qcs.co.uk
Flu Guidance for Care Homes
As COVID-19 is likely to be co-circulating with flu, protectingthose at high risk of flu, who are also those most vulnerable tohospitalisation as a result of COVID-19, is vitally important.
For most healthy people, flu is an unpleasant but usuallyself-limiting disease with recovery generally within a week.However, there is a particular risk of severe illness fromcatching flu especially for:
This year people are also recommended to have the fluvaccine if they are:
Control measures to prevent the spread of the SARs-CoV-2 virus such as shielding and social distancing will mean that delivering the flu vaccine this year will be more challenging as flu vaccines are to be delivered in a very different way than in previous years and a range of different ways of delivering the programme this year will be considered. Flu immunisers will need to wear personal protective equipment (PPE) in keeping with the advice that is current at the time of delivering the flu vaccine.
Older people
The main carer of an older or disabled person
Those with underlying disease, such as chronicrespiratory or cardiac disease
Household contact of someone on the Shielded Patients List for COVID-19
Those who are immunosuppressed
5
t: 0333 405 3333 w: www.qcs.co.uk
Flu Guidance for Care Homes
Pre-season preparation
Staff responsibilities
Providers must ensure that Residents have access to the vaccine as early as possible. This year it is also important that all staff are encouraged to have the flu vaccine.Public Health England advise that all eligible people should be vaccinated by the end of December before the flu starts circulating. However given the concern with COVID, early immunisation is recommended
Advanced preparation is vital for a successful programme to achieve high vaccine uptake.
To ensure that as many people as possible have theflu vaccine, the home can set up a progamme withstaff and residents being vaccinated at the same time
To make it as easy as possible for staff to access theflu vaccine programme, consider flexibility for shiftworkers if staff not on the premises at the time of thesession(s). Some back-up provision should be madefor these staff e.g. appointment at the GP surgeryif a second opportunity for flu vaccines in the homeisn’t possible
Have a lead member of staff with responsibility forrunning the flu immunisation campaign
All staff should know who the lead person is
All staff should understand the reason for theprogramme and have access to PHE resources – it is recommended that everyone living in a residential ornursing home has the flu vaccine
Every member of the team should know their role and responsibilities
Get all staff involved in promoting the vaccine messageto residents and their families
Reassure residents that they will receive an inactivated vaccine that does not contain any live viruses and cannot give them flu. Usually, they will be offered one that contains an adjuvant that helps the immune system create a stronger response to the vaccine. It is offered to people in the 65 and over age group because as people age their immune system responds less well to vaccines
Hold regular meetings so that all staff know the home flu plan and how it is progressing
Contact the local GP surgery as soon as possible to discuss how and when the flu vaccination programme will be delivered to residents
6
t: 0333 405 3333 w: www.qcs.co.uk
Record the number of employees with direct resident contact and the number receiving the vaccine so that uptake can be measured
Consider using a ‘declination’ form where staff sign and give a reason for non-vaccination which can improve uptake as it makes refusal a conscious decision rather than ‘not getting round to it’. It can also provide useful information to inform planning for future seasons
At the end of the season review the campaign, discuss and record successes, challenges and learning points for next year
Update the Capacity Tracker
Further considerations
If necessary, prioritise those who were extremely clinically vulnerable and on the COVID-19 shielded patient’s list (SPL). This prioritisation should include staff and residents who are most at risk
Include other healthcare professionals linked to your care home in your planning
Consider the implications if the situation changes and there is an increase in the transmission of COVID-19 in the community, especially in the event of a local lockdown
Flu Guidance for Care Homes
7
t: 0333 405 3333 w: www.qcs.co.uk
Print Name:
I DO NOT WANT A FLU VACCINE. I acknowledge that I am aware of the following facts:
DOB:
Influenza is a serious respiratory disease; on average,290,000 and 650,000 people globally die every yearfrom influenza-related causes.
Influenza virus may be shed for up to 24 hours beforesymptoms begin, increasing the risk of transmission toothers.
Some people with influenza have no symptoms,increasing the risk of transmission to others.
The influenza virus changes often, making annualvaccination necessary.
I understand that the influenza vaccine cannottransmit influenza and it does not prevent alldisease.
I have declined to receive the influenza vaccine for the 2020-2021 season. I acknowledge that the influenza vaccination is recommended by the Department of Health and Social Care for all health and social care workers to prevent infection from and transmission of influenza and its complications, including death, to patients, my
co-workers, my family, and my community.
2020-2021 Staff Influenza Vaccine Declination Form
8
t: 0333 405 3333 w: www.qcs.co.uk
I decline vaccination for the following reason(s). Please tick all that apply.
Knowing these facts, I choose to decline vaccination at this time I have read andfully understand the information on this declination form.
1. I am declining the influenza immunization for one of the justified reasons. Please tick all that apply and provide detailson the back of the page.
2. I do not wish to take the vaccine for the following reasons – Please check all that apply.
Severe allergies to eggs, vaccine components, or prior influenza vaccines. Describe your reaction:
History of Guillain-Barre Syndrome.
I don’t believe this vaccine is important.
Declaration of another medical contraindication.
I don’t like needles.
My philosophical or religious beliefs prohibit vaccination.
I never get the flu.
I have reacted to flu vaccines: (Check below)
Redness, swelling Body aches, low fever
Got the flu after receiving the vaccine
Had to see a doctor
2020-2021 Staff Influenza Vaccine Declination Form
Local pain
9
t: 0333 405 3333 w: www.qcs.co.uk
Print Name
Phone Number
Manager’s Name
Department
2020-2021 Staff Influenza Vaccine Declination Form
Date
Signature
10
t: 0333 405 3333 w: www.qcs.co.uk
THEME:
1. COVID-19
What should we be doing? How can we do it? Are we doing it?
Be aware of, review and follow the latestguidance provided by the Government andother agencies
Make sure we have procedures in place to share information internally/externally
Have regular team meetings to shareinformation
Have COVID-19 as an item onsupervision agenda
Check the understanding of the person receiving the information
Be proactive with commissioners, health services, CQC, other agencies and the wider Local Authority
Ensure that there is a person responsible for monitoring latest guidance
Discuss changes in management meetings, and the implications for the service
Ensure that the service is signedup for alerts from DHSC/PHEMake contact with local provider forums / alliances. Join a membership body eg. NCF and NCA to ensure you have sector support and can share ideas
Sign up to be part of any local provider forums
Leadership and How to Preparefor and ‘Thrive’ During LikelyChallenges Experienced DuringWinter 2020
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
11
t: 0333 405 3333 w: www.qcs.co.uk
Prepare for a ‘second wave’
Set up a system to ensure that relatives can visit
Review visiting policy as outside space may not be viable during the winter
Where possible plan areas for visiting that ensure the safety of everyone but promote person-centred care
Consider setting up an essential carer procedure in the event of local lockdown
Communicate your visitor code. Ensure each resident has a visitors care plan in place
Undertake a review of how the service is managing COVID-19
Reflect on any previous lessons learned
Where accessing testing is problematic, escalate to your local Health Protection Team
Document the review to provide evidence that you are focusing on improvement
Involve staff, residents, external stakeholders, and relatives and loved ones
Be honest and open about where you could have done better
Share updated plans and processes
Understand during winter COVID-19 may be combined with additional pressures such as Flu, Norovirus and other health concerns
Build capacity into your plans to ensure a sufficient pipeline of staff
Ensuring that you have sufficient testing kits Use online ordering systems and be persistent in approach
Plan for the future andassess/predict how many kits you will need in the future considering possible second wave, or local ‘spike’
Consider the storage of the kits
Include in your staff plan who will resource the testing process
Where accessing testing is problematic, escalate to your local Health Protection Team
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
12
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
Assess the levels of PPE stock and supplies that will be required
Order sufficient PPE stocks now toensure that if/when demand increasesover winter you have stocks available,and are not forced into purchasingpoorer quality, or PPE at an increased costKeep in contact with your suppliersand develop a positive relationship
2. FLU
What should we be doing? How can we do it? Are we doing it?
Vaccinations
Ensure that staff are vaccinatedagainst flu, and make all theappropriate arrangements and receiverelevant consents
Liaise with health professionalsregarding the vaccination of residentsto ensure they are prioritised
Develop a recording system for staff and people using the service to keep a record of who has been vaccinat-ed, and any reasons why they are not being vaccinated
Start a flu campaign to promoteawareness of the importance of the vaccine
Consider including within yourcampaign, ‘Flu Myth busters’document to improve the update rate. The WHO has some examples
Consider people who have dietary restrictions or needs. Alternatives to the standard flu vaccine for vegans are available
Learning form COVID-19 Understand what learning from COVID-19 is transferable to the management of flu in the service
Develop a flu plan based on best practice guidance and any learning from COVID-19
Implement RESTORE2 training to support staff to recognise early deterioration in residents
13
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
3. STAFFING
What should we be doing? How can we do it? Are we doing it?
Understanding staff needs
Rota planning Develop a rota in conjunction withstaff and where possible includeindividual requests
Look at developing ‘cohorts’ of staff that work in teams to reduce chances of infection spread
Set up 1:1 meetings with staff to discuss their wellbeing, any concerns they may have and the impact of COVID on their personal circumstances. For example, hold individual wellbeing meetings with staff to understand about personal circumstances and COVID-19 concerns.
Consider implications for the service. For example, does the staff member have elderly relatives, other caring roles, children of school age or uses public transport?
Support each staff member and develop Wellness Action Plans .
Carry out risk assessments for all staff to identify and staff who may be vulnerable to COVID-19 or flu
14
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
Assessing skills, knowledge and experience Ensure that the rota has a balanceof necessary skills to meet the needs of the people using the service
Develop and publish future rotas for a longer period than usual to make staff aware of when they are working. This will assist with winter period pressures and promote a proactive approachfocused on working together
Carry out a risk assessment based on your workforce to understand the im-pact of COVID in local schools andhow that may affect your service. Eg. large numbers of staff with children at the same school. Staff with school aged children having to respond to fluctuating start/finishing times at
Assess how many staff have to use public transport. Consider how therisks can be reduced with staffavoiding peak travel times wherever possible
Undertake a skills audit of the staffteam and identify any shortfall
Assess your training provision toensure that it supports a reablement/outcome focussed approach that promotes independence for residents,
When arranging training, be futurethinking and look at what possibleareas of need may be moreimportant over the winter period. For example: nutrition, falls, tissueviability, infection control, hygiene and health monitoring
15
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
Build on ‘good will’
Planning inductions
Take the opportunity to build on your reputation and actively commence recruitment even if at the current time there are limited opportunities
Use the rapid induction resources from Skills for Care to develop a clearinduction plan. Ensure staff understand how to apply infection controlrequirements within the home
Use existing staff to assist ininductions, share experience
E- Learning for Health has free CareCertificate Course to support staffinduction
4. RECRUITMENT
What should we be doing? How can we do it? Are we doing it?
Reviewing Staffing Resource Pool
Relationships with agencies
Ensure you have sufficient pools ofstaff who can work exclusively foryour service
Explore recruitment strategies torecruit new staff such as refer a friend schemes
Use local networks developed duringthe COVID-19 pandemic to recruitnew staff
Build on the enhanced reputation ofsocial care and the service youprovide
Highlight the positives and benefits ofworking for the service
Where the use of agency staff cannot be avoided, work with suppliers to ensure you have exclusivity with individual staff so avoid the spread of the virus.Avoid using staff that work between multiple homes
Online training Be proactive in researching onlineofferings and technological solutions to training
16
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
5. SUPPLIES/SUPPLIERS
What should we be doing? How can we do it? Are we doing it?
Relationships with suppliers Open communication with suppliers
Pay them promptly, as this will assist with them responding positively to requests
Contact suppliers regularly to stay in touch, even if you do not require anything at the present time
Review who you get supplies from and see if you could rationalise and focus on specific suppliers –base this on quality of products and value provided
Where there are shortages of supplies communicate this via the Capacity Tracker
Reviewing potential need
Long term contracts
Review the amount of stock youneed, and plan for potential futuredemand
Review contracts that you haveand see if there is any benefit ofnegotiation and formalising/extendingcontract period
If stock is non-perishable, then review winter needs now and order sufficient quantities, especially relevant forhygiene products and PPE
Do not stockpile, particularly withmedicines
Work closely with commissioners to explore new opportunities fordevelopment or expansion whereappropriate
17
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
6. ENVIRONMENT
What should we be doing? How can we do it? Are we doing it?
Hygiene
Adverse winter weather preparation
Ensure that robust audits are carried out on at least a monthly basis, more frequently over winter period as infections are more easily spread
Document the finding from the audits and highlight the action required and completed. Using your quality framework ensure that the audits and actions are agenda items at quality meetings
Management should walk the floor every day with a particular focus on cleanliness and hygiene
Ensure that adequate supplies of salt are available to manage icy pathways
Shovels and other items to support safe entry and leaving the premises must be available
Ensure that all servicing is up to date on heating, lighting, lifts, kitchen appliances, washing machines and other laundry equipment etc.
Staff are aware of the need toreport any issue with the environment, and management respond effectively
Ensure staff understand the COVID safer travel guidance if they are considering car sharing
18
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
‘No deal’ plan
Business continuity
The management of the service must develop a plan for ‘no deal’ and what the potential impact will be on the service. This could include:
The Business Continuity Plan must be reviewed and updated to reflect the possible implications of a ‘no deal’ Brexit
Staffing – new recruitmentopportunities and the rights ofexisting staffMedical supplies, includingpharmaceuticals
Costs and availability of products
Food and catering requirement
Financial implications
Maintenance supplies andequipment include spare parts
7. BREXIT
What should we be doing? How can we do it? Are we doing it?
Aware of government guidance Management must keep up to datewith the changes as a result of Brexit
When appropriate, relevant information should be shared with staff
19
t: 0333 405 3333 w: www.qcs.co.uk
Leadership and How to Prepare for and ‘Thrive’During Likely Challenges Experienced During Winter 2020
8. MANAGEMENT OVERSIGHT
What should we be doing? How can we do it? Are we doing it?
Quality monitoring
Monitoring audits
Developing action plans to address quality issues
Statement of Purpose
Developing evidence
Developing local networks, sharing resources
Keep notes on any quality inspections/audits and ensure details of action plans are retained
Ensure that there is an annual plan of audits with evidence of continual improvement
Develop with staff and ensure thatthe person accountable for actioning has the necessary experience tocomplete them
Make sure the Statement of Purpose is kept up to date
Set up a file to collate all regulatory evidence and review evidence monthly or earlier
Attend local networks; this is a greatopportunity to network and find out about new initiatives and share ideas
Ensure that any changes to the service are reflected in the document
Many continue to hold meetingsvirtually during the pandemic
Attend networking events such asCare Roadshows to hear from subjectmatter experts and enhance yourknowledge
All audits to be filed for easy reference with action plansEnsure that all action plans arereviewed and updated with a reason detailing why an action has not been met
21
t: 0333 405 3333 w: www.qcs.co.uk
• Ensure the home has the capacity to care for the resident?• Has the resident’s condition changed? Are there additional/
different needs?• Do staff need additional training before they are discharged
especially in relation to COVID?• And more generally - do they need rehab/ recovery support.
A cough or a loss of, or change in, normal sense of smell or taste (anosmia) may persist in some individuals, and is not an
indication of ongoing infection when other symptoms have resolved.
Testing is available via the Care Home portal Symptomatic care home workers (and anyone with symptoms that lives in the same household as a care home worker) can arrange a test at either a Regional Testing or Mobile Testing Site, or choose to receive a home testing kit delivered direct to their door by visiting the onlineself-referral portalComplete whole home testing Follow guidance on staff who are symptomatic and repeat testing
• •
•
Existing resident identified by the hospital or another social care facility as fit for discharge
COVID-19 test results must be shared by the hospital prior to discharge. This test must have been conducted within 48
hours prior to discharge
Resident must be isolated for 14 days in their room • Set up room and follow Outbreak Management Policy,Infection Control and Prevention Policy and guidance.
• Does the resident have cognitive impairment that may makeisolation challenging?
• Do you have sufficent PPE? Are you able to cohort resident?• Keep the Capacity Tracker updated
Set up a system for COVID testing staff and residents
COVID-19 Admission and Discharge Actions for Care Home Residents
22
t: 0333 405 3333 w: www.qcs.co.uk
COVID-19 Admission and Discharge Actions for Care Home Residents
Continue to encourage social distancing and good handhygiene for residents
Review appointments (medical and non-medical) that would involve residents visiting a hospital or other healthcare
facilities and discuss with the healthcare providerwhether these can be delivered remotely
Access training on RESTORE2 and NEWS for staff to support recognising early deterioration in residents
Residents who are known to have been exposed to a person with possible or confirmed COVID-19 (an exposure similar to a household setting), should be isolated (or cohorted if notpossible) with other similarly exposed residents who do not have COVID-19 symptoms until 14 days after last exposure
23
t: 0333 405 3333 w: www.qcs.co.uk
Ensuring a Safe Hospital Discharge Checklist - A Communication Tool
Guidance notesThis checklist is to support safe discharges from hospital and prevent unnecessary readmission to hospital
Where there are any concerns that the discharge may not be safe, the member of staff who hasresponsibility for making decisions about the needs of residents must be informed before it is confirmed a resident will be accepted back into the home
Make notes of any information and repeat information back to discharge provider to check information iscorrect
Do not allow interruptions until full handoff process completed including communication with relevant staff in the home
Record the information using the home’s record keeping procedures
Document the expected discharge date clearly
Make sure that night staff/weekend staff are aware of the planned discharge
Ensure the COVID-19 status of the resident is recorded and that a COVID-19 test has been carried out in 48 hours prior to discharge
File this form in the resident’s file
The staff member receiving the information about the discharge has the responsibility for ensuringinformation is recorded correctly and escalated appropriately.
•
•
•
•
•
•
•
•
•
•
24
t: 0333 405 3333 w: www.qcs.co.uk
Ensuring a Safe Hospital Discharge Checklist - A Communication Tool
Description Information Required Checklist
Introduce
Background
State your name and the name of your home
What has happened to the resident inhospital?
Record date and time of the call
Will this medication be sent with the resident?
Confirm name and address and DOB ofresident
Any manual handling issues/falls in hospital?
Any changes to health needs?
Any new equipment?
Any changes in mental capacity status?
Ask the name of the Discharge Caller, Ward/Unit and Hospital, Respite Provider
What is their medication on discharge?
Confirmed
Insert your name
Add to notes
Insert details
Add to notes
Insert date Insert time
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Insert resident’s name
Insert resident’s DOB
25
t: 0333 405 3333 w: www.qcs.co.uk
Ensuring a Safe Hospital Discharge Checklist - A Communication Tool
Description Information Required Checklist
Background
Any Pressures Area concerns e.g. change in Waterlow Score?
Has a COVID-19 test been carried out in the last 48 hours (prior to discharge)?NB: do not accept any resident where COVID status has not been checked in the 48 hours prior to discharge.
Is the COVID-19 Test positive or negative? (Circle)
Does the resident still have any symptoms of COVID-19? (Circle)
CoughTemperatureLoss of smell/taste
• ••
Any changes to family circumstances?
Confirmed
Yes
Yes
Yes
Positive
Yes
Yes
Yes
Yes
No
No
No
Negative
No
No
No
No
26
t: 0333 405 3333 w: www.qcs.co.uk
Description Information Required Checklist
Background
Has the Social Service Team been informed by Hospital of the expected date of discharge (EDD in line with national guidance)
Do staff need additional training?
Has next of kin been informed of EDD?
Confirmed
Notify relevant staff at end of call of EDD, include all discharge information and timings
Yes
Yes
Yes
Do any changes need to be made to ensure safe isolation?
Do any additional infection control measures need to be implemented?
Yes
Yes
No
No
No
No
No
Ensuring a Safe Hospital Discharge Checklist - A Communication Tool
Timings
What is expected date/time of discharge?
What will happen next?Anticipated changes?What is the plan?Are there contingency plans?
Is transport being used?
Insert date/time of discharge
Yes No
27
t: 0333 405 3333 w: www.qcs.co.uk
Medical Information
Medication Changes
Other
Notes
Your Name
Your Role
Date of Call
Ensuring a Safe Hospital Discharge Checklist - A Communication Tool
32
t: 0333 405 3333 w: www.qcs.co.uk
Communication
29
t: 0333 405 3333 w: www.qcs.co.uk
Communication Audit
A barrier to communication is defined as an obstacle that prevents an exchange of ideas or thoughts. There are many barriers to effective communication and these barriers may appear at any stage of the communication process. For clear, effective communication, messages need to be heard properly and understood.
Social Care itself has its own language and jargon. One of the risks of this is that where staff use words or phrases that are specific to the sector or even to the service itself, it may have a completely different meaning to the person receiving the message. Poor communication is frequently cited in serious case reviews with poor multi-agencycommunication as a major root cause of incidents arises.
For residents who have hearing, visual impairments or who have cognitive impairments, communication can bechallenging. The wearing of PPE can magnify these issues and make them feel isolated and raise anxiety levels.
It is important that providers do everything possible toidentify barriers to good communication and developstrategies to overcome these to ensure positive outcomes and wellbeing for all residents.
The audits within this section are designed to support you to explore how well your service communicates, between staff, residents, families, and external partners. Once you have audited where you are, use the action plan to address any shortfalls. A good idea is to share findings with your teams, with residents and their families and involve them inidentifying ways to improve. You can then keep thisinformation to show CQC the evidence of your quality systems and processes
30
t: 0333 405 3333 w: www.qcs.co.uk
Communication Audit
Month Year
The audit score ratings must be populated by the Organisation. These must be based on the local risks associated with this audit theme.
1 = Standard MetScoring Criteria 0 = Standard Not Met
Action plan to be completed for any section scoring 0
Audit Area – Communication - General
Audit Area – Residents
0/1
0/1
Comment
Comment
The communication needs of individual staff are documented during the onboarding process with the service.
Any communication methods are continually reviewed with themember of staff to ensure that they remain supported.
Where further support is required, this is evidenced, and the service liaises with external organisations.
There is evidence of training for staff to support others with theircommunication needs.
Resident’s communication methods are documented during their pre-assessment with the service.
Communication methods are continually reviewed as part of the care planning process at the service.
Where there are sensory impairments for residents, alternativecommunication methods have been sourced.
There is evidence of communication with external professionals, where alternative communication is required.
Each resident receives a Resident Guide on admission allowing them to become familiar with the service’s policies and procedures.
There is evidence that residents are supported to communicate with their families and loved ones.
The service offers documentation in a variety of communicationmethods, for example large print, braille, audio, easy read etc.
Staff are aware of the Accessible Information Standard.
There is evidence of regular staff team meetings taking place.
Different forms of staff communication are in place for examplenoticeboards, newsletters, one on one communication, factsheets etc.
31
t: 0333 405 3333 w: www.qcs.co.uk
Action Plan
Audit Completed by:
Signed:
Date:
Verified By:
Signed:
Date:
Total Score : /15
Red Amber Green
Audit Area – Residents 0/1 CommentWhere a resident does not have capacity, they are supported under the Mental Capacity Act 2005 with the best communication methods for them.
There is evidence of staff being trained in alternative forms ofcommunication. For example, sign language, sensory devices, braille etc.
Communication Audit
32
t: 0333 405 3333 w: www.qcs.co.uk
Communicating with External Partners
Month Year
The audit score ratings must be populated by the Organisation. These must be based on the local risks associated with this audit theme.
1 = Standard MetScoring Criteria 0 = Standard Not Met
Total Score : /12
Action plan to be completed for any section scoring 0
Audit Area – Partnership Working 0/1 Comment
The service has regular meetings with external agencies on projects that require partnership working.
Where the home is going to be working with external partnersintroductory meeting are arranged for all parties involved.
There is evidence of co-production meeting advertisements incommunal areas of the service.
Any external meetings are documented by the service and held in line with the service’s Storing of Records Policy.
There is evidence that any joint working considers how individuals like to communicate and how they like to receive information.
Where possible, residents are invited to participate in meetings to help shape services.
Correspondence on co-production meets a service user’s preferred communication method, for example an advertisement, newsletter or one on ones with the resident.
An annual survey is sent out to residents to collect their views on the resident.
There is evidence that surveys are sent out to staff to gauge their views on the resident.
A comments box is in place at the service to allow staff, residents and visitors, including relatives, to communicate their views about the service.
Outcomes from co-production meetings are communicated to all residents, staff and relatives/advocates where required.
There is evidence of working with local partners with the serviceworking towards a common localised goal.
Red Amber Green
33
t: 0333 405 3333 w: www.qcs.co.uk
Action Plan
Audit Completed by:
Signed:
Date:
Verified By:
Signed:
Date:
Communicating with External Partners
34
t: 0333 405 3333 w: www.qcs.co.uk
Month Year
1 = Standard MetScoring Criteria
The audit score ratings must be populated by the Organisation. These must be based on the local risks associated with this audit theme.
Action plan to be completed for any section scoring 0
0 = Standard Not Met
Audit Area – Staff Communication 0/1 Comment
State your name and the name of your home
Total Score : /11
There is evidence that staff have been trained in the use of the policies and procedures of the service and know how and where to access the most up to date versions.
There is evidence of allocated reading lists being created to ensure that staff are aware and have read any recent updates.
There is evidence that there is a clear handover procedure andchanges in health, needs etc. are clearly communicated.
Meetings have agendas and minutes that are available to staffincluding those who work at night/weekends.
There is evidence the service is aware of the communication needs of its staff.
Staff are trained in the requirements of the Data Protection Act
Staff are trained to support residents and other staff with any communication difficulties they may have.
The service’s policies and procedures are available in accessible formats. For example, large print, easy read documents etc. where required.
Communication of updates takes place in a variety of forms, forexample, newsletters, email, supervisions, factsheets, meetings,handovers, notice boards.
Red Amber Green
Staff Communication Audit
35
t: 0333 405 3333 w: www.qcs.co.uk
Action Plan
Audit Completed by:
Signed:
Date:
Verified By:
Signed:
Date:
Staff Communication Audit
36
t: 0333 405 3333 w: www.qcs.co.uk
Month Year
1 = Standard MetScoring Criteria
The audit score ratings must be populated by the Organisation. These must be based on the local risks associated with this audit theme.
0 = Standard Not Met
Action plan to be completed for any section scoring 0
Audit Area – Residents, Relatives and Advocates 0/1 Comment
The service has a clear communication plan in place to inform residents and their relatives/advocates of any developments.
Noticeboards are updated regularly with information by a designated person at the service.
The manager offers an open-door approach to residents and their relatives/advocates.
Total Score : /10
There is evidence that the communication plan is being followed by the service, for example weekly correspondence is being sent out etc.
A newsletter is produced regularly to support good communication for both residents and their relatives/advocates.
Regular contact is made with relatives/advocates by the service.
There is a clear process to manage any feedback received in the form of complaints, compliments etc. by the service.
There is evidence that any actions from satisfaction surveys have been completed, where necessary.
There is evidence of satisfaction surveys being completed which evidence how residents, relatives/advocates feel in relation to regular service updates.
The preferred communication methods of all residents and their relatives/advocates are documented.
Red Amber Green
Residents, Relatives & Advocates Audit
37
t: 0333 405 3333 w: www.qcs.co.uk
Residents, Relatives and Advocates Audit
Action Plan
Audit Completed by:
Signed:
Date:
Verified By:
Signed:
Date:
38
t: 0333 405 3333 w: www.qcs.co.uk
External Communication Audit
Month Year
1 = Standard MetScoring Criteria
The audit score ratings must be populated by the Organisation. These must be based on the local risks associated with this audit theme.
0 = Standard Not Met
Action plan to be completed for any section scoring 0
Audit Area – External Communication 0/1 Comment
The service can evidence working with external partners such as local hospitals and authorities etc.
There is a clear admissions and discharge process within the service.
There is a clear handover process in place.
Total Score : /10
Documentation is kept recording external communication such as referrals, admissions, and discharge paperwork.
Communication records are in evidence prior to admission or discharge to support the safe transfer of the resident.
Where identified, communication and information needs have been shared with external partners.
Staff are trained to communicate with external partners, in line with the policies of the service.
Feedback from external partners is sought to support theimprovement of the service.
All communication is conducted in line with the Data Protection Act.
There is evidence of working with other providers locally during COVID-19.
Red Amber Green
39
t: 0333 405 3333 w: www.qcs.co.uk
Action Plan
Audit Completed by:
Signed:
Date:
Verified By:
Signed:
Date:
External Communication Audit
44
t: 0333 405 3333 w: www.qcs.co.uk
Quality of Life
41
t: 0333 405 3333 w: www.qcs.co.uk
Supporting People to Stay Connected
With more and more local lockdowns and an increasing number of COVID cases how to support
residents and their families to stay connected is high on the agenda.. Unfortunately, the looming
second wave means restricted visits, no hugs and limited face to face contact with loved ones. This
lack of connection can leave residents with cognitive challenges feeling even more isolated and their
families feeling anxious and helpless.
Video calls like Skype, WhatsApp and Zoom may have become second nature to some of us now but
for those with cognitive difficulties, confusion or sensory challenges or even those who are new to
technology it can leave people frustrated and even more confused. Video calls can be reassuring for
both parties to see each other again so how can we support our residents and their families to get the
most out of this and keep those connections open?
Guidance –Supporting peopleto stay connected
42
t: 0333 405 3333 w: www.qcs.co.uk
Supporting People to Stay Connected
Trial how the person interacts with technology.
Choose a quiet area with no distractions.
Choose a time of day when the person is likelyto be most receptive.
Ensure the screen is set up properly and givefamily tips on how to do the same.
If you’re not sure how someone will engage with a video call, have a little practice first to minimise frustration. If a resident isn’t used to technology it may seem scary. For people with dementia they may struggle to communicate with a screen as they think it is a TV and cannot understand that they can interact with it. Aim to keep it short to begin with.
Background noise can be off putting and distorted.
Evening calls may be better for family members who are working butevenings may not be ideal for residents. For residents with dementiathey may be tired and may have sundowning symptoms. It is alsoimportant to choose a time when a member of staff can give their fullattention to supporting the video call to maximise chances of success.
Phone screens may be too small so an iPad or computer wouldbe better. Sit at a desk or table if possible. Sit at eye level to thecamera so upper body and head are visible. Close curtains ifbacklight is causing shadows or blurring as this can be very confusingfor someone with visual and perceptual problems as their brainstruggles to process the information their eyes receive.
43
t: 0333 405 3333 w: www.qcs.co.uk
Supporting People to Stay Connected
Communication tips.
Join them in their reality for this moment.
If you’re not sure how someone will engage with a video call, have alittle practice first to minimise frustration. Someone with dementiamay struggle to communicate with a screen as they think it is a TVand cannot understand that they can interact with it. Aim to keepit short to begin with.
This time is precious so avoid arguing and accept confabulation. Ifconversation is difficult, use the time for reminiscence. Looking at oldphotographs or listening to a familiar tune together and singing alongcan rekindle positive emotions and enhance feelings of connection.
Those with hearing difficulties may cope better with a telephone call. This may be challenging as the person on the other end cannot gauge reactions or emotion through body language. Ensure hearing aids or amplifiers are used and use the communication tips above.
If technology is still getting in the way and is causing more problems than it solves then it is down to you to keep that connection to family alive. Regular photo and video updates can provide much needed reassurance to loved ones. Encourage families to send photos postcards and gifts and make time to talk about them and reassure that family are thinking about them and that they are loved, valued and cared for.
44
t: 0333 405 3333 w: www.qcs.co.uk
Recognising Loneliness, Social Isolation, or Withdrawal
Recognising loneliness,social isolation,or withdrawal
Loneliness and isolation have been described as endemic in a continually changing world, affecting all age groups. It has become a significant part of public health attention and input, in the form of policy, strategy, supports and guidance.
There have also been many research studies carried out and books written on the subject, especially concerning the effect on physical and mental health.
While loneliness and isolation can occur at any age, there is a significant increase with age.
It is important to note that social isolation is an objective state – defined in terms of the number of social relationships and contacts – loneliness is a subjective experience.
The terms social isolation, emotional isolation and loneliness are often used to describe loneliness, but they are, in fact, three separate entities:
Solitude is the state ofbeing alone
Isolation is a lack of social relationships or emotional
support
Loneliness is a craving forsocial contact. It is often
linked to feelings ofsadness and emptiness
45
t: 0333 405 3333 w: www.qcs.co.uk
More detailed descriptions are found in Good Therapy.
Solitude
Emotional Isolation
Social isolation
Spending time alone is not inherently wrong. Solitude can be a healthy, rejuvenatingexperience. It can allow people to reconnect with their needs, goals, and feelings.Some people require more solitude than others. Introverts, for example, enjoyspending lots of time alone and can feel drained through social interaction.
Occurs when someone is unable or unwilling to share their emotions with others. Someone may be reluctant to discuss anything but the most superficial matters.Without emotional support, they may feel “shut down” or numb. Emotional isolation can occur due to social isolation.
Meanwhile, extroverts often need more social interaction to feel fulfilled. Circumstances that feel isolating or lonely to one person may be healthy for another.
https://www.goodtherapy.org/learn-about-therapy/issues/isolation
The absence of social contact and/or networks, even within close communities.A person can experience social isolation, whereby they:
Spend extended periods alone
Avoid social interaction due to shame or depression
Experience social anxiety or fears of abandonment at the idea ofsocial interactionHave only limited or superficial social contact
Lack of meaningful social or professional relationships
Develop severe distress and loneliness
Recognising Loneliness, Social Isolation, or Withdrawal
46
t: 0333 405 3333 w: www.qcs.co.uk
Recognising Loneliness, Social Isolation, or Withdrawal
Early warning signs
Prevention and Intervention
There are steps that staff, carers and other supporters can take to minimisethe risks of loneliness, isolation, and withdrawal. These are described in manypublications, and the common themes are as follows:
Low self esteem
Depression or anxiety
Abandonment fears
Discomfort in social settings
Refusing social contact
47
t: 0333 405 3333 w: www.qcs.co.uk
Knowing the individual
Life stories/histories are invaluable in getting to know a person, not only theirlikes and dislikes but their hopes, aspirations, ambitions, fears and at a basic level, what a good day is for them.
The critical aspect here is giving individual choices.
Besides, this knowledge can help staff, carers and supporters identifychanges in the individual that may be an early warning of withdrawal orperhaps a downturn in mood/mental health.
It is also vital to ensure that eyesight and hearing are checked regularly, asthese can hider social interaction.
Raise awareness of opportunities
There is a diverse range of opportunities to consider not just within the confines of a care service or home, and there is a broader community to consider, either to invite in or visit.
These three psychological approaches that are researched and documented:
A few suggestions are:
Group-based support (based on shared interests)
Direct one-to-one support
Signposting to other services
Develop new relationships (such as the use of befriending services)
Psychological approaches
Promote physical activity
Promote and enable volunteering
Utilise technology and digital solutions
Building safer communities
Community Wellbeing Practices (e.g. choir)
Cognitive behavioural therapy
Mindfulness Positive psychology
Recognising Loneliness, Social Isolation, or Withdrawal
48
t: 0333 405 3333 w: www.qcs.co.uk
A growing third sector
The third sector has an important dual role to play in tackling socialisolation and loneliness. Third sector organisations are generally rootedwithin their communities and are well-positioned to offer interventionsand support in a different way to statutory services. What services areavailable in your community?
Asset-based communitydevelopment (ABCD) models
Parish, community or town councils are useful links to establish to help enable individuals to feel part of the wider community and have a say on what is planned and suggest ways in which the community can be improved and made safer. Copies/extracts of the minutes of meetings can also be included in newsletters
Churches, places of worship, religious and cultural beliefs - ensuring that individuals have access to their church, place of worship, and the social connection and support that can be given is important
Community Navigator service – check to see if there is such a service in your area
Links with the broader community
ABCD models can be used within the broader community but can also be used within smaller communities such as care homes and neighbourhoods. What are the community assets within your community?
Recognising Loneliness, Social Isolation, or Withdrawal
49
t: 0333 405 3333 w: www.qcs.co.uk
https://www.goodtherapy.org/learn-about-therapy/issues/isolation
https://www.local.gov.uk/loneliness-social-isolation-and-covid-19-practical-advice
https://www.ageuk.org.uk/information-advice/health-wellbeing/loneliness/a-life-less-lonely/
https://www.neighborhoodtransformation.net/pdfs/What_%20is_Asset_Based_Community_Development.pdf
https://www.gov.scot/publications/connected-scotland-strategy-tackling-social-isolation-loneliness-building-stronger-social-connections/pages/10/
https://www.scie.org.uk/prevention/connecting/loneliness-social-isolation/#:~:text=The%20impact%20that%20loneliness%20and%20social%20isolation%20can,to%20health%20as%20smoking%2015%20cigarettes%20a%20day.
https://campaigntoendloneliness.org/guidance/
https://www.campaigntoendloneliness.org/wp-content/uploads/Promising-approaches-to-reducing-loneli-ness-and-isolation-in-later-life.pdf
http://www.cpa.org.uk/information/reviews/CPA-Rapid-Review-Loneliness.pdf
Further reading:
Recognising Loneliness, Social Isolation, or Withdrawal
50
t: 0333 405 3333 w: www.qcs.co.uk
Name: Date of Birth:
Conducted by:Assessment date:
Screening Question
Issue Agreed Intervention
Yes No
Does the individual have any physical, mental or life limiting conditions?
Is the individual confined to bed, use a wheelchair or walking aid?
Does the individual suffer from any type of incontinence?
How much time does the individual spend alone?
Have eyesight and hearing tests been done recently?
Can the individual communicate verbally or non-verbally?
Has the individual experienced a recent significant loss?
Has a life story/history been completed?
How are the hopes, aspirations and ambition in the life story/history met?(if not, can these be altered in able for them to be met to some degree?)
Is the individual a member of any groups within the service or in thecommunity?
Does the individual have family and/or close friends with whom they choose to have contact?
For individuals with a diagnosis of dementia only - Has the serviceemployed the use of SOFI?
Is the individual able to go out independently or do they require assistance/supervision?
Screening Checklist for Social Isolation-Withdrawal
51
t: 0333 405 3333 w: www.qcs.co.uk
Screening Checklist for Social Isolation-Withdrawal
Date of review
52
t: 0333 405 3333 w: www.qcs.co.uk
There are various types of delirium, sometimes called hyperactive, hypoactive, and mixed. The mixed type is when hyperactive and hypoactive states come and go.
Over the past six months, we have learned COVID-19 is not solely a lung disease but involves the brain as well. Manypeople with COVID-19 have experienced delirium.
Although COVID-19 specifically targets the lungs, the damage it causes can include other major organs, especially the brain. There are common causes of delirium (the mnemonic- Pinch Me to help you remember the causes
ain
nfection
utrition
onstipation
ydration & Hypoxia
edication & Metabolic
nvironment
In hyperactive delirium, the Residentbecomes agitated and restless
In hypoactive delirium, the Resident is drowsy and withdrawn
P
I
N
C
H
M
E
COVID-19 Delirium Factsheet
53
t: 0333 405 3333 w: www.qcs.co.uk
Delirium is characterised by confusion, difficulty in paying attention, and trouble organising thinking.
People with delirium may have auditory hallucinations, visual hallucinations, disorientation of time and space,agitation, aggression, fluctuating level of consciousness, and impairment of sleep-wake cycle.
The hallucinations may keep them in a constant state of fear. A Resident with delirium may think much more timehas passed than is true in the ‘real’ world. These beliefs will seem real to the
Resident and they will not be able to tell they are not real.
Memory difficulties and speech that is tangential, disorganized, or incoherent.
The duration of delirium is one of the strongest predictors of dangerous outcomes including higher death rates,longer stay, and acquired dementia a year after surviving the Intensive Care Unit.
Older people are at the greatest risk from COVID-19. If infected they may present with or develop a delirium.However, delirium is not exclusive to older people and may well be seen in any Resident with severe infection,adult respiratory distress syndrome, and those requiring invasive ventilation on ICU units.
Diagnosing and treating the underlying causes of delirium.
Ensure that any issues with low oxygen levels are resolved. Low blood pressure, Low glucose level (blood sugar),and drug intoxication or withdrawal can all contribute to delirium
Continue to treat other conditions the Resident has such as COVID-19
Manage medication the Resident is taking for other conditions. Ask for a Review of current medications; ensureoptimal pain management (use Bolton Pain Scale if required); treat any constipation
Ensure that the Resident is sitting and moving correctly, reducing noise. Helping the Resident get a good naturalsleep (e.g. reducing noise and lighting at night-time)
Prevent the Resident becoming immobile, dehydrated, malnourished, or isolated
Ensure that good oral hygiene continues and that the Resident has their dentures
Communicate clearly and carefully and allow plenty of time when assisting the resident. Support any sensoryimpairments - make sure people have their hearing aids and glasses
Consider risk to self and others due to current symptoms (e.g. aggression, accident, self- neglect, physicaldeterioration, infection risk to others in context of COVID-19)
Break down complicated activities; regular reorientation and explanation; acknowledge distress andvalidate feelings
Provide reassurance and continue to promote independence
Support the Resident’s family, it can be very distressing for both the resident and their love ones
Further Guidance: COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community:NICE guideline [NG163] Published date: 03 April 2020 Last updated: 30 April 2020
COVID-19 Delirium Factsheet
54
t: 0333 405 3333 w: www.qcs.co.uk
Resident Name Room Number
Rehabilitation (Post COVID-19) Care Plan Template
Mrs Smith can manage her everyday tasks, with increasing mobility day on day. Her energy levels are
improving
Mrs Smith eats small meals frequently with a diet rich
She is feeling positive and happy in mood
Mrs Smith can experience breathlessness, feels weak with stiffness in her joints and has trouble in doing
everyday tasks
She is disinclined for diet and feels very fatigued with low mood
Abilities, preferences, wishes:
Support needed from staff:
What does a good day look like?W hat does a not so good day look like?
Record the following: What does Mrs Smith’s normal day look like (prior to COVID-19 illness and relatedconsequences), what would she do for herself in relation to everyday tasks, hobbies and interests, e.g.gardening, listening to radio, going out for walks and meeting friends
Record results from any of the tools used e.g. Peak Flow Meter, Physiotherapy exercise regime
State any health care professionals who are involved with Mrs Smith e.g. Physiotherapist, CPN
Explore if Mrs Smith is suffering from discomfort; is she experiencing stiffness or pain in her limbs? Support
Help Mrs Smith plan her day by breaking down tasks to small steps with rest periods in between and prevent exhaustion, observe the times of the day when most tired and avoid doing too much at that time
Ensure that Mrs Smith has everything she will require for the forthcoming day within easy reach and consider different ways of completing tasks
Cross referencing to any community psychiatric nurse’s (CPN) guidance notes and advice
Ensure that time is given to Mrs Smith to listen to her fears and anxieties about recovery, reassure her to take small steps and consider recording these steps to demonstrate progress
•
•
•
•
•
•
•
•
•
•
Rehabilitation Post COVID-19 Care Plan Template
55
t: 0333 405 3333 w: www.qcs.co.uk
Associated documents in place:
Care Plan review: (Full details of the review and who was present should be recorded within the daily record. Use this section as a quick glance tool only)
Who was involved in producing Jane Smith’s Care Plan
Physiotherapy exercise plan
Geriatric Depression Scale
Protocol from CPN (psychological behavioural plan)
Pain Assessment Chart
PRN Protocols for analgesia
Outcome measures such as COPM (Canadian Occupational Performance Model), Barthel Index or NEADL (Nottingham Extended Activity of Daily Living
•
•
•
•
•
•
Name:
Mrs Jane SmithS Resident 25/08/2020x
Mr John SmithS Resident's son 25/08/2020x
Mrs Key Worker Key Worker 25/08/2020x
Role: Signature: Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Date:
Change:
Change:
Change:
Change:
Change:
Change:
Change:
Change:
Change:
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
Initial:
Initial:
Initial:
Initial:
Initial:
Initial:
Initial:
Initial:
Initial:
Rehabilitation Post COVID-19 Care Plan Template
56
t: 0333 405 3333 w: www.qcs.co.uk
Intervention
Advice for Individualsin recovery phasePace
Many individuals experienced a devastating effect on their body after having the Coronavirus. Some may still have physical and psychological difficulties during recovery.
Physically they may have breathlessness, feel very weak due to lack of appetite, stiffness in their joints or fatigue. Psychologically, many feel low in mood, anxious or irritable, problems with memory and thinking, or they may experience sleeping problems with nightmares or flashbacks of their hospital experiences. Feelings of concern about their recovery, especially if they were fit and well before their COVID illness. This is common in people who have had a serious illness that has required hospital treatment. These symptoms might make normal activities feel difficult and tiring to do.
Slow down. Do not expect to be able to do everything at once, or at the pace you used to do. Do less than you think you can
Break activities into smaller tasks and spread them throughout the day. You will recover faster if you work on a task until you are tired, rather than completelyexhausted
Build rests into your tasks and plan 30-40 minutes of rest breaks between activities. Resting is key to recharging your energy
•
•
•
It is important to be patient; take things slowly andgradually build up the daily and weekly routine. There are lots of simple things people can do to help themselves. Get-ting enough sleep and making sure they eat well will both help. It is important to conserve energy when completing everyday tasks.
Try following the 3 P’s Principle – Pace, Plan and Prioritise when completing your daily activities.
COVID-19RECOVERY
Guidance on Managing Post COVID-19 Recovery
57
t: 0333 405 3333 w: www.qcs.co.uk
Plan PrioritiseLook at the activities you normally do on a daily and weekly basis; develop a plan to spread these evenly across the week
Think about which activities you find most tiring and make sure you spread these out, with plenty of time to rest in between
Do not try to complete several activities all in one go. This will drain your energy, and you will need more time to recover afterwards
If you find that your energy is lower or concentrating is harder at certain times of day, plan to avoid tiringactivities at these times
Think about ways you can do activities differently to make it easier and less tiring. For example, you could sit down during tasks like washing and getting dressed. Rather than lifting and carrying items when cooking, try pushing and sliding them across the work surface instead.
Rearrange rooms like the kitchen so the items you use most are easy to reach
Simple pieces of equipment can make lots of daily tasks easier to manage. Websites such as livingmadeeasy.org.uk will help you to find equipment that might be useful to you
Some daily activities are necessary, but others are not. There might be some tasks that you usually do that you can stop altogether, do less often or ask someone else to do for you
When prioritising activities make sure you have a balance of things you need to do, like washing and dressing and things you want to do for fun and enjoyment
Start the day by asking:
What do I need to do; what do I want to do today?
What can I put off until another day?
What can I ask someone else to do for me?
1.
2.
3.
•
•
•
•
•
•
•
•
•
•
Your COVIDRecoveryTo support people who are experiencing the mental and/or physical effect of COVID-19, the NHS has launched awebsite to provide support: Your COVID Recovery has a range of resources to support individuals.
Pace, Plan &Prioritise
Guidance on Managing Post COVID-19 Recovery
58
t: 0333 405 3333 w: www.qcs.co.uk
QCS supports over 90,000 customers in the health and social care sector to comply with regulatory standards, preparefor inspections and provide best practice.
PhoneEmailWebsite
:::
0333 405 33 [email protected]
