Protecting care homes
The Council’s Commissioning Team provides guidance to care homes on preventing infection and transmission.
The Council speaks to all care homes daily. These calls and the use of data provide assurance that residents and staff are safe. They also ensure a fast response to any concerns.
Protection measures for care homes include:
Infection prevention and control
Clinical staff across Middlesbrough have had training from a specialist infection control nurse.
Staff from South Tees NHS Foundation Trust provide extra advice on prevention and control. This includes risk assessments and how to manage care homes.
Care homes will be able to apply for grants via the Council to make further improvements. These could include improved hygiene facilities, changes designed to make visiting safer, and the creation of isolation areas.
Personal Protective Equipment (PPE)
The Council responded quickly to PPE shortages and purchased it in advance of the outbreak period. A stock was built up to help care homes follow national guidance.
The Council also coordinated the distribution of PPE around the Tees Valley. This stock was accessed through the government and Local Resilience Forum.
The Council has developed a directory of PPE supplier information and costs should care homes need further support.
Care home staff have been trained on the use and quality of PPE.
All patients discharged from hospital to a care home are tested for COVID-19. Results are shared with the home for the protection of all residents.
Residents and staff with COVID-19 symptoms are tested by the local NHS community nursing team.
Staff with symptoms can also book a test at James Cook University Hospital or the Regional Test Centre at Cannon Park.
Residents and staff without symptoms have access to Mobile Testing Units.
All care homes in Middlesbrough are being supported by the Council to access testing.
NHS England & Improvement research is establishing the number and frequency of tests needed in care homes.
NHS England & Improvement is also assessing testing capacity in our region. This is designed to make sure we can respond properly in the event of an outbreak.
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 with assistance from an Emergency Care Practitioner or Advanced Nurse Practitioner.
Safe isolation of residents without causing distress has been challenging.
The local mental health trust provides advice on support for residents who lack capacity to take decisions on their care and treatment.
The government has published guidance on reopening care homes to family members, friends, informal carers, health professionals, and others. The guidance says that the local Director of Public Health should give a regular assessment of whether visiting is likely to be appropriate. Read the most recent assessment from the Director of Public Health – 31 July 2020 (PDF).
Dealing with outbreaks in care homes
In the event of two or more confirmed or suspected cases, care homes contact Public Health England’s North East Health Protection Team.
South Tees Hospitals NHS Foundation Trust is also notified. The trust’s community nursing team then carries out swab testing.
Testing will also be arranged for any residents or staff who go on to develop symptoms. Support for residents with symptoms during an outbreak will be overseen by the Care Homes Enhanced Support Service. This is provided by the local GP Federation.
When notified of exposure to Covid-19 in a care home, the Health Protection Team will begin gathering data and providing advice.
Guidance will be given on infection prevention and control measures. The team will carry out a risk assessment and check on procedures. This will involve considering isolation, social distancing and PPE for staff.
If the team is assured appropriate measures are in place no further action will be taken.
The Health Protection Team will report to the Council’s Director of Public Health when:
- There are one or more cases in a care home where there have not been cases in the previous 28 days
- In any situation where there are one or more cases in staff or residents since the last report was issued
- Where there is concern about measures, staffing or resources in a home.
The Council’s Operational Response Team will review the information and the Council’s Director of Public will decide on the response.
The Council’s Public Health Consultant will decide whether to put together a team to manage the response.
Any response could include any or all of the following:
- Infection prevention and control support
- Extra or different PPE supplies
- Staffing support in the event of staff having to isolate
- Support with business continuity planning
- Isolation within a care home
- More testing
The team would include representatives from the care home, NHS and the Council’s Public Health, Public Protection and Communications teams.
Technical advice would be provided by the Public Health England North East Health Protection Team. The Health Protection Board would also advise where necessary.
If an outbreak causes a significant test to the system’s capacity to respond, a declaration of an emergency or major incident would be considered.
This would be escalated to the Local Resilience Forum Gold Command and emergency response would begin.
Large numbers of care home staff being infected or required to self-isolate is the most likely scenario that would lead to this action.
In the event of this situation the safe operation of the care home and safety of residents would be under threat.