BNSSG IPC&M Care Provider Bulletin

 

Care Provider Feedback Form: Vaccination Uptake Flu & Covid
Staff vaccination is an important part of infection prevention within social and domiciliary care but uptake of flu and Covid vaccination was relatively low, this winter. We are keen to work with people from within care settings to understand the reasons for this and explore what we could do differently, next winter, to increase staff vaccination uptake.

Please complete this vital feedback by 19 February 2024. Click on the button below:

Care Provider Feedback Form - Vaccination Uptake Flu & Covid (Please complete by 19 Feb 24)

New Guidance for ARIs

Dear Adult Social Care Providers

The National Guidance for the management of Acute Respiratory Infections (ARIs) in Adult Social Care Settings has changed. The previous Covid-19 supplement has been expanded to include all common Acute Respiratory viruses e.g. COVID, flu, RSV, parainfluenza, rhinovirus etc and is now referred to as the ARI Supplement.

Infection prevention and control in adult social care: acute respiratory infection - GOV.UK (www.gov.uk)

Summary of key changes are:
 

  • Definition of an outbreak – Two or more cases of ARI (including COVID-19, Flu, RSV, rhinovirus etc) within 5 days. This is updated from the previous COVID-19 definition of 14 days and brings it in line with all other viral respiratory infections.

  • Testing for COVID-19 – For care homes only, test up to 5 residents who developed symptoms most recently, rather than the first 5. This is to be able to identify the cause of infection in the individuals likely to be most infectious. You will no longer need to upload your test results onto the online testing portal.  However, you should keep a record of any test results even if negative or void.

  • Isolation/exclusion periods– have remained almost the same for COVID-19 i.e. those who test positive should self-isolate/exclude themselves from work for a minimum of 5 days from date of symptom onset (as opposed to the test date) and until they no longer have a fever and are feeling well enough to carry out their usual daily activities and for a maximum of 10 days.  For those who are symptomatic but have not tested or test negative, they should stay away from others until they no longer have a fever and are feeling well.

For any other respiratory viruses, the HPT will advise on recommended Isolation/exclusion (by email and/or verbally, once you have reported an outbreak)

  • PPE - face masks to be worn when within 1 metre of someone with confirmed or suspected ARI. This is updated from the previous recommendations of 2 metres. Gloves and aprons should only be used subject to risk assessment and only if there is a risk of exposure to blood/body fluids.

  • Health & Wellbeing - new section on ensuring service user wellbeing while supporting symptomatic individuals to stay away from others. (e.g. ensuring visiting, supporting them to leave their room for fresh air etc.) 

  • An emphasis that visiting should be maintained (with appropriate safeguards, reductions and risk assessments). Further, more detailed national guidance expected soon

Other changes include updates on: symptoms and symptom monitoring; vaccines; and treatments. Please see links below for updates for more details on the changes.
 

ARI in ASC List | ARI OB Poster

 
The Care OBRA has been updated to align with the new guidance. Please continue to use the web-based Care OBRA Tool to report all NEW suspected or confirmed OUTBREAKS of ACUTE RESPIRATORY INFECTIONS (ARIs) e.g. Flu, COVID-19, RSV or unidentified ARI)
 
You do NOT have to ring or email the HPT before reporting your ARI outbreak (ARI ONLY!) use the link: Care Outbreak Risk Assessment (Care OBRA) Tool for Acute Respiratory Infections (ukhsa.gov.uk)
 
After reporting your outbreak via Care OBRA, you will receive an automated Acknowledgement Email and an Advice Email.  If these emails classify your outbreak as High Priority AND it is a weekend or public holiday, you must also call the HPT.

  • You may also use the Care OBRA to report SINGLE CONFIRMED cases of FLU.  If you have a single case of flu (usually only confirmed in hospitalised patients) please check to make sure that you do not have any other suspected cases in your setting.  If so, then report as an outbreak

  • You do not need to report further cases in an existing outbreak or cluster unless you have cause for concern as stated above or have been asked to do so

  • You do not need to report single cases of COVID-19

  • You do not need to report cases that you are certain are UNLINKED to transmission in the setting

  • Do NOT report other types of outbreak e.g. norovirus using the Care OBRA Tool

Please explore our SW Infection Prevention and Control and Winter Readiness Toolkit for lots of useful resources, including links to relevant national guidance and as well as SW Checklists, posters, information sheets etc https://swcouncils.gov.uk/ukhsa-care-home-and-residential-care-guidance/ 

Please find attached the ARI Outbreak Poster – When and How to Contact the HPT, which includes the live link and QR code to the Care OBRA Tool webpage.
 
You should report your outbreak as soon as it is recognised (and for care homes only: please test up to five of your most recently symptomatic cases by COVID-19 LFD, if possible, before completely the Care OBRA).  This is particularly important for suspected or confirmed flu outbreaks, as the HPT is likely to recommend flu antivirals to treat cases and prevent flu in those exposed.  Antivirals are most effective when started early.

UKHSA Infection Prevention and Control and Winter Readiness Toolkit for Care Homes and other Residential Care Settings

Our tool kit is designed to help managers and staff in care homes and other residential care settings with planning and preparation for infections and outbreaks (that are often particularly frequent during the winter season), and in outbreak recognition and management.

We provide links to important national guidance plus some quick-reference locally developed resources, designed to be used as needed for your setting, by staff, residents, relatives and visitors.

UKHSA Care Home and Residential Care Guidance - South West Councils (swcouncils.gov.uk)

Test Kit Supply

Test Kit Supply - How to access tests for outbreak testing in a care home: Care homes regulated by the CQC can access COVID-19 tests to identify whether COVID-19 is causing an outbreak.

  • Care homes can place an order for free COVID-19 tests online to be used in the event of a suspected outbreak using their Unique Organisation Number (UON). Enough tests should be ordered to test up to 5 (or more, if requested by the HPT) residents with symptoms to identify if COVID-19 is causing an outbreak. Care homes should check to ensure they have sufficient stocks of tests for outbreak testing that are in-date.

How to access tests for people eligible for COVID-19 treatments in a residential care setting

  • Care providers can access tests on behalf of service users who are eligible for COVID-19 treatments and therefore, eligible for symptomatic testing.

  • Tests for this purpose are supplied by the NHS and should be accessed from a local pharmacy. Providers should speak to their usual pharmacy (for example those that provide residents’ medicines) or other local pharmacy to discuss access arrangements and whether the pharmacy is able to deliver tests in addition to collection options.

  • Pharmacies may ask questions about an individual’s medical history to confirm eligibility for free tests and update patient records for future test orders.

More details from the NHS about this service can be viewed here, NHS England » NHS Lateral Flow Device (LFD) Tests Supply Service: Advanced Service and more information on availability of testing for treatments is available at Who can get a free NHS COVID-19 rapid lateral flow test.

PPE 
All care staff should use appropriate PPE in line with risk assessments and the hierarchy of controls to reduce the spread of infection and other risks associated with certain care tasks. Unpaid carers, personal assistants and visitors to residential care settings should also use appropriate PPE where advised.

For PPE to be effective:

  • all staff should be trained in the correct use, safe donning and doffing and disposal of PPE

  • visitors to care homes, personal assistants and unpaid carers should be advised on the correct use of PPE and service users should be informed of why PPE is being used

  • people should clean their hands before putting on and after taking off PPE

  • PPE should not be re-used unless they are marked as reusable and are appropriately decontaminated between use

  • PPE should be put on and removed at least 1 metre away from care recipients

Infectious clinical waste including waste visibly contaminated with respiratory secretions (such as sputum or mucus from the mouth and nose) generated from an individual who is considered infectious, should be treated like any other infectious clinical waste, following national regulations and in line with the IPC resource for adult social care.

Due to the increasing numbers of infection we have included the link below to allow care providers to access Free PPE until Mar 2024.
Free personal protective equipment (PPE) scheme - GOV.UK (www.gov.uk)

 
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