Adult Social Care: Updated Infection Prevention and Control guidance and new COVID-19 supplement
Gillian Keegan MP, Minister of State for Care at the Department of Health and Social Care, has issued a letter to care providers and care managers outlining the key changes due to form the updated infection prevention and control (IPC) guidance for adult social care, replacing the current suite of COVID-19 guidance.
Key changes:
Vaccines
Vaccination as a condition of deployment (VCOD) is no longer a legal requirement for health and social care settings.
The COVID-19 supplementary guidance sets out that providers should:
Encourage and support all their staff to get a COVID-19 vaccine and a booster dose as and when they are eligible, as well as eligible older adult care home residents to receive a Spring booster.
Put arrangements in place to facilitate staff access to vaccinations for COVID-19 (and seasonal influenza) where possible and regularly review the immunisation status of their workforce, in line with ‘The Green Book.’
Undertake risk assessments to ensure the safety of people who receive care wherever possible, taking into account the COVID-19 vaccination status of both staff members and the people they care for.
Consider taking additional steps such as wider IPC measures and prioritising the deployment of vaccinated staff to care for those who are higher risk of severe COVID-19 infection where proportionate.
PPE
Recommendations on the use of PPE remain broadly unchanged. As previously announced, the government will provide free PPE for COVID-19 needs until the end of March 2023, or until guidance is substantially amended.
FFP3 masks will no longer be recommended when undertaking AGPs if the person is not suspected to have a relevant infection. In this situation, a Type IIR fluid resistant surgical mask will provide appropriate protection.
Testing
From 4 April, the government will continue to provide tests to the sector to help manage the spread of COVID-19, prioritising groups most at risk of infection, and reducing testing requirements where possible to ease the additional burden testing places on care services. As set out in the guidance:
Testing will remain available for staff in care homes, extra care and supported living services, homecare organisations and day care centres, as well as personal assistants, social workers, Shared Lives workers and CQC inspectors.
Asymptomatic staff testing will be changed from daily LFDs before work to twice weekly LFDs during periods of high prevalence. This will ensure testing continues to identify positive cases to protect those most vulnerable to COVID-19 and align ASC staff testing with the NHS.
Symptomatic testing will be changed to two LFDs taken 48 hours apart, available for all Adult Social Care staff, as well as residents in care homes and extra care and supported living services. All regular asymptomatic resident testing will end.
For those who test positive, free LFDs will continue to be available to allow staff to return to work earlier. Individuals should test from day 5, ending isolation early after two consecutive negative tests taken 24 hours apart.
Free daily LFDs will also be available to enable 5 days of rapid response staff testing in the event of a single positive case in care homes or high-risk extra care and support living settings. In care homes, free PCR and LFD tests will also continue to be available to manage outbreaks.
Visitors to care homes will no longer need to test before entering but are asked to take necessary precautions to keep themselves and their loved ones safe, in line with general population guidance.
A small number of visitors who are providing personal care will be asked to test before entering when prevalence is high, up to twice weekly if visiting more than twice, with free LFD tests available for these visitors during periods of high prevalence.
End of life visits should continue to be supported in all circumstances.
NHS staff, CQC inspectors and social workers will continue to have access to free
testing during periods of high prevalence and should show evidence of negative tests up to twice weekly prior to entry to a care home. Visiting professionals who provide personal care will also be asked to test before entering in the same way as visitors providing personal care with tests provided to the care home for this purpose. All other visiting professionals will not need to test prior to entry.
Residents should continue to be tested on admission to care homes, with free tests provided by the NHS for those being discharged from hospital and free tests provided to care homes for those entering from the community or another care setting.
Unpaid carers who do not live with the person they care for will continue to be able to access free PPE.
Isolation for care home residents
Care home residents will no longer be asked to isolate following high-risk visits out of the care home (including following emergency hospital stays) and will not be asked to take a test following a visit out.
Residents will only be asked to isolate for 10 days if they test positive for COVID-19 or if they are discharged from an area of a hospital in active outbreak, or if the care home is in outbreak. Free LFD tests will remain available to end isolation as soon as possible to minimise the impact on resident wellbeing. Individuals will continue to be able to test from day 5, ending isolation early after two consecutive negative tests taken 24 hours apart. Every care home resident should be enabled to receive one visitor during their period of isolation, who can visit at any time.
Staff movement
From 4 April, there will no longer be a requirement to restrict the movement of care staff between settings. Staff movement still carries a risk, and there may be circumstances where providers are asked to limit staff movement by the local Director of Public Health or Health Protection Team (HPT) - for example, if there is high prevalence of COVID-19 locally or in an outbreak.
Discharge of COVID-positive patients into care homes
From 1 April care homes will be able safely to accept COVID-positive people when they are discharged from hospital, removing the need to place residents in an unfamiliar setting before moving again.
If a home admits someone who is COVID-positive they should isolate them from residents who have not tested positive, and where possible, have staff dedicated to their care. A care home can refuse to admit a resident if they do not feel able to care for them safely.