Protecting care homes

The Council provides guidance to care homes and other care settings on preventing infection and transmission.

The Council speaks to all care homes regularly. These calls and the use of data provides assurance that residents and staff are safe. Any concerns are responded to urgently.

Protection measures for care homes include:

Infection prevention and control 

Specialist infection prevention and control (IPC) staff from South Tees Hospitals NHS Foundation Trust provide advice and guidance.

Detailed risk assessments, settings management and in-depth training for staff in care homes are available.

Support for domiciliary care and social care sector including supported living, extra care settings, children’s homes and other non-commissioned providers such as day centres has been secured.

Personal Protective Equipment

Middlesbrough Council purchased PPE at scale in advance of the first outbreak period. A stock was built up to ensure care homes could follow national guidance.

Middlesbrough Council also co-ordinated distribution of stocks across the Tees Valley. This supply was accessed via government and the Local Resilience Forum.

Testing in care homes

All patients discharged from hospital to a care home are tested for COVID-19. The results are shared with the home to support safe management of their residents.

In the event of a positive COVID-19 result, alternative arrangements are in place to allow people to isolate safely.

All staff and residents in care homes, supported living and extra care settings receive regular coronavirus tests.

Staff are tested weekly using polymerase chain reaction (PCR) tests and twice weekly using lateral flow device (LFD) tests.

Residents are tested monthly using PCR kits.

Staff can now take the LFD tests from home. In the event of a positive result via LFD, staff must have a follow-up PCR test and should follow self-isolation guidance until results are confirmed.

Any positive results in the care home, either from LFD or PCR, will require all staff in the care home to be tested with LFD kits for 7 consecutive days.

Testing is now in place for all visitors to care homes using LFD tests. This includes visiting professionals and relatives. Visits are subject to any local and national restrictions.

All family and friend visitors to care homes should be tested each time they visit with an LFD test. Visitors must wear appropriate PPE throughout the visit and follow all infection prevention and control measures.

If a visitor receives a positive result, they should conduct a follow-up PCR test. The visitor should then to self-isolate at home immediately to await their result.

Clinical Support

Unwell residents who have tested positive or are suspected of being positive are responded to urgently.

This is arranged by the Care Home Enhanced Support Service (CHESS), with assistance from an Emergency Care Practitioner or Advanced Nurse Practitioner.

Safe isolation of residents who have tested positive or showing symptoms without causing distress has been challenging.  The local mental health trust provides face to face and virtual clinics to advise on the support for residents who lack mental capacity to take decisions relating to their care and treatment.

Dealing with outbreaks in care homes

In the event of two or more confirmed or suspected cases of COVID-19, care homes and other care settings contact Public Health England’s North East Health Protection Team (HPT).

Should an outbreak be confirmed, the HPT will arrange testing for all residents and staff.

When notified of an exposure to COVID-19 in a care setting, the HPT will gather data and provide advice.

The HPT will do a risk assessment and check on procedures in place in the home regarding isolation, social distancing and PPE for staff.

If the HPT is assured that all appropriate measures are in place no further action will be taken.

The HPT will inform the Director of Public Health when:

  • There is a new outbreak declared in a care setting with one or more cases of COVID-19 who have not had cases in the preceding 28 days;
  • All cases where there is one or more cases in staff or residents since the last report was issued; or
  • Where there is concern about a home e.g. failing to adhere to control measures, staffing or resource issues.

The Local Response Team is responsible for reviewing the information provided by the HPT, including the initial risk assessment and advice given.

When further local action is required, the Director of Public Health will be responsible for convening the appropriate Outbreak Response Team.

The Public Health Consultant would decide on the appropriate response.

This could include any or all of the following:

  • Infection prevention and control support
  • Additional or different PPE supplies
  • More staff
  • Isolation
  • Extra testing

The team will include representation from: the care setting; Council commissioning, public health and public protection and Communications teams; NHS Community Teams.

Expert technical advice will be provided by the HPT and where necessary the Health Protection Board.

If the outbreak causes a significant test to the system’s capacity to respond, consideration will be given to the declaration of an emergency or major incident.

The most likely escalation scenario is if large numbers of staff are infected or required to self-isolate.

The safe operation of the care home and safety of residents would be under threat in those circumstances.