Changes to the universal use of face masks in adult social care for COVID-19
This newsletter is for Care Homes
Changes to the universal use of face masks in adult social care for COVID-19
Today (15 December) the Government has announced three changes to COVID-19 measures in care homes:
The risk-based use of face masks across adult social care. Increased autonomy to initiate COVID-19 outbreak management risk-assessments should care homes feel able to do so, with support available from Health Protections Teams where needed. Streamlined outbreak testing for small care homes.
Full details of these changes can be found in the COVID-19 supplement to the infection prevention and control resource for adult social care and the COVID-19 testing in adult social care, as well as a letter to the sector from the Director of Adult Social Care delivery in the Department of Health and Social Care. Care homes should move to the update guidance by 22 December, but services can begin to implement new guidance before this as soon as they feel able to do so.
The risk-based use of face masks across adult social care
This updated COVID-19 supplement to the infection prevention and control resource for adult social care guidance details the risk-based use of face masks, which replaces previous guidance that stated face masks should be worn at all times across adult social care. Decisions on mask use should balance the risk of infections spreading with any risks or benefits that arise from the use of masks. Services should follow updated guidance and continue to engage with staff and people receiving care to inform decisions on when masks should be used. As set out in guidance, and underpinned by a risk assessment, masks should continue to be used by:
A staff member caring for a person suspected or confirmed to have COVID-19. A staff member who is a household or overnight contact of someone with COVID-19. Staff and visitors if there is an outbreak of COVID-19 in the settingA staff member if the person receiving care prefers a carer to wear a mask
The use of masks may also be considered if caring for someone who is particularly vulnerable to severe outcomes from COVID-19 on an individual basis and in accordance with their preferences. Mask wearing may also be considered when an event or gathering is assessed as having a particularly high risk of transmission.
COVID-19 outbreak management risk-assessments
The Government has streamlined decision-making in the event of a COVID-19 outbreak so that care homes can initiate their own risk-assessments should they feel able to do so. This means care homes can determine and implement proportionate and risk-based outbreak measures relevant for the individual setting. As part of the updated COVID-19 supplement to the infection prevention and control resource for adult social care guidance, care homes should:
Continue to inform the local health protection team (HPT) of a suspected outbreak as per previous guidance, but updated guidance means they are no longer required to wait for advice from the HPT (or other relevant partner) should they feel able to initiate a risk assessment independently. Follow updated guidance set-out in the COVID-19 supplement to the Infection Prevention and Control resource for adult social care to establish if cases are linked and determine outbreak measures if opting to initiate the risk assessment.Ensure any measures implemented are proportionate, risk-based and temporary.Continue to facilitate some form of visiting during an outbreak. In all circumstances, each resident should as a minimum be able to have one visitor at a time inside the care home and end-of life visiting should always be supported. Initiate outbreak testing and rapid response testing as soon as possible in line with updated guidance as set-out in the COVID-19 testing in adult social care. Providers do not need to wait for HPT advice to do so.Ask for further support where necessary from the local HPT (or other local partner) if they need further advice or if there are specific issues of concern. Further details are outlined in the updated guidance.
Care homes can begin to initiate their own risk assessments in the event of a suspected outbreak when they feel able to do so. Providers should inform staff, residents, and their loved ones if a home is in outbreak as well as any measures that have been applied.
Outbreak testing changes for small care homes
The Government regularly reviews the latest evidence to ensure testing is proportionate and following analysis of outbreaks in small care homes (defined as 1 to 10 beds), we are streamlining outbreak testing for these settings.
The COVID-19 testing in adult social care guidance has been updated meaning:
Small care homes no longer need to undertake PCR recovery testing of all staff and residents 10 days after the last individual developed symptoms or tested positive, unless advised by an HPT or other relevant local partner.The outbreak can be declared over once all resident self-isolation periods are over. This does not alter when staff should return to work which is outlined in the COVID-19 supplement to the Infection Prevention and Control resource for adult social care.Small care homes should initiate outbreak testing as soon as possible if two or more cases are identified as there is a higher likelihood that the cases are linked due to the close networks in small settings. Small care homes may opt to undertake both rapid response and outbreak testing or just outbreak testing. Please refer to COVID-19 testing in adult social care guidance to determine if rapid response testing has value.Small care homes should continue to undertake rapid response testing in the event of one positive case to help determine if an outbreak may be occurring.Small care homes can manage resident cases similarly to a household, with residents encouraged to follow advice for the general population. Providers should also continue to act quickly to support individuals diagnosed with COVID-19 wo are potentially eligible for COVID-19 antiviral treatments.
A care home should determine and be prepared to evidence that small care home guidance applies to them if the size of the care home is above 10 beds. For example, if there are individual units or floors with completely separate staff and residents who do not mix with other staff and residents outside of this unit or floor.
We hope that these changes will empower providers and staff to make decisions on appropriate measures and help ensure that ongoing IPC measures are proportionate.
Vaccines remain the best way to protect people from COVID-19 and flu. Staff and people receiving care are encouraged to get their COVID-19 vaccinations, including boosters as soon as they are eligible. Social care workers and eligible care recipients can book their appointments for both a Covid Autumn booster and flu vaccine via the National Booking Service or by contacting their GP.
Staff, service users and visitors are encouraged to continue to follow infection, prevention and control guidance. This, alongside vaccination and other important measures such as therapeutics and targeted testing will continue to protect people across adult social care.
Test kit delivery over the Christmas period
Our test kit delivery team will be working at reduced capacity over the Christmas period and will only be able to fulfil urgent test kit requests placed between 22 December – 29 December. If your requirement is not urgent, please do not place orders during this period.Thank you to you and your staff for your continued efforts,
NHS Test and Trace