Changes to Visiting Guidance (Dec. 30th)
The visiting guidance has been updated again. There is one key change in the guidance which is that those who are visiting out of the care home, who are fully vaccinated, now only need to take an LFD every other day for a 10 day period rather than every day. In addition, they have reiterated the statement around nominated visitors, making it clear that they should be unchanged wherever possible.
Care home residents who have had 2 doses of the vaccine, or are exempt from vaccination, should not have to isolate for 14 days after most visits out of the care home, but should take a lateral flow test every second day for 10 days following the visit out.
The updated guidance can be found here.
UPDATE DECEMBER 29TH
Government provides extra £60 million to local authorities for adult social care over January 2022
- Government announces £60 million top-up to local authorities to support adult social care sector in the new year
- This is on top of £388 million already being provided to prevent infections and provide testing
- It comes as Omicron cases increase rapidly across the country
The government will provide an extra £60 million to local authorities to support the adult social care response to COVID-19 in January, Minister for Care Gillian Keegan has announced today.
The Adult Social Care – Omicron Support Fund is on top of the £388 million infection control and testing fund announced earlier in the year to prevent infections and provide testing in the care sector.
As cases of Omicron rise rapidly around the country, the additional £60 million will help protect both those who receive care, the family and friends who support them, as well as the adult social care workforce. Local authorities can use the funding to support the sector and protect people from COVID-19 infection. This includes investing in improved ventilation, increasing the use of Direct Payments – which are offered to people with eligible social care needs so they have choice and control over their care and support arrangements – or paying for COVID-19 sickness and self-isolation pay for staff.
Minister for Care Gillian Keegan said:
“Protecting care staff and people who use social care services continues to be a priority, especially as cases surge and Omicron spreads rapidly around the country.
“Today’s extra funding will ensure that we continue to support adult social care to keep people safe and prevent outbreaks. A huge thank you goes out to care workers for all they are doing to care for people and keep themselves and others safe this winter.
“I urge anyone who has yet to get a booster to come forward – vaccines are our best defence against this virus so Get Boosted Now.”
The government has taken action throughout the pandemic to protect social care, including:
- Continuing to provide free PPE to protect against COVID-19 to the adult social care sector;
- Providing regular asymptomatic COVID-19 testing; and
- Continuing to support care providers to make best use of technology to help remote monitoring including making pulse oximeters available to care homes that have less than the recommended number of devices.
Care home guidance was changed recently to protect residents further by allowing each resident to have three listed visitors as well as an essential care giver, either a family member or friend, who may visit the home to offer companionship or help with care needs. People living in care homes are typically more vulnerable to severe illnesses as a result of COVID-19, and measures are in place to facilitate visiting while keeping care home staff and residents safe. Visitors should receive a negative lateral flow test result and report it on the day of their visit.
DHSC Update Dec 23rd
If you are experiencing issues obtaining stocks, your LRFs and/or DPH should have some emergency stocks.
Thank you for getting in touch and thank you for flagging, unfortunately these are not isolated incidents and it is recognised that demand for LFTs is very high right now. At present is it not possible for home care providers to bulk order LFDs as they are not part of their regular asymptomatic testing regime as outlined in guidance, however I do appreciate they need access to LFDs to ensure adherence to daily testing if someone has been a contact, these should be obtained through the universal testing offer or pharmacy collect. As LFD testing is not part of the regular asymptomatic testing for home care 119 will not be able to help providers obtain LFD, so we would advise against sending providers down this this route.
We’re looking to increase the supply both of LFTs but also delivery slots (unfortunately this is coinciding with one of the busiest times of the year for delivery companies and Royal Mail) for the universal offer and to get more tests out to pharmacies. More delivery slots are also released periodically online at https://www.gov.uk/order-coronavirus-rapid-lateral-flow-tests and although inefficient checking this regularly may be a way to secure a slot.
We are very sorry for the inconvenience, and appreciate the challenge this presents, we are aware and working on it. Please do let me know if you hear of any other issues with testing and test supply.
DHSC Head of Social Care Testing Policy
Updated Guidance Dec 23rd.
Updates to testing guidance: care homes, supported living and day centres
Following the announcement on 10th December which included updates to testing guidance, please see below for the updated guidance. Care home staff are now being advised to increase testing from 2 lateral flow tests (LFTs) per week to 3 as well as a weekly PCR test. This change in guidance also applies to high risk extra care and supported living services and day care centres.
High risk extra care and supported living – https://www.gov.uk/government/publications/coronavirus-covid-19-testing-service-for-extra-care-and-supported-living-settings/testing-service-for-extra-care-and-supported-living-settings
This is from the updated Management of Exposed Healthcare Workers and patients in Hospital Settings Guidance (published today) https://www.gov.uk/government/publications/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings/covid-19-management-of-exposed-healthcare-workers-and-patients-in-hospital-settings:
2.2 If a staff member receives a positive SARS-CoV-2 PCR test result
If a staff member receives a positive SARS-CoV-2 PCR test result, they must complete a period of self-isolation. The isolation period includes the day the symptoms started (or the day their PCR test was taken if they do not have symptoms), and the next 10 full days.
Staff may be able to end their self-isolation period before the end of the 10 full days.
They can take an LFD test from the sixth day of their isolation period, and another LFD test on the following day. The second LFD test should be taken at least 24 hours later. If both LFD tests results are negative, they may end their self-isolation after the second negative LFD test result. They should not take an LFD test before the sixth day of their isolation period and should only end their self-isolation following 2 consecutive negative LFD tests which should be taken at least 24 hours apart.
Staff may then return to work if they meet the following criteria:
- the staff member should not have any COVID-19 symptoms
- the staff member should continue to undertake daily LFD tests for the remaining days of isolation period. For example, if the first LFD test was taken on the sixth day, and the second LFD test was taken on the seventh day, they should continue to take LFD tests on day 8, 9 and 10. If the first LFD test was taken on the seventh day and the second LFD test was taken on the eighth day, they should continue to take LFD tests on day 9 and 10
- if any of these LFD test results are positive the staff member should isolate and should wait 24 hours before taking the next LFD test
- if the LFD test is positive on the 10th day, daily LFD testing should continue, and the staff member should not return to work until a single negative LFD test result is received
- on days the staff member is working, the LFD test should be taken prior to beginning their shift, as close as possible to the start time
- the staff member must continue to comply with all relevant infection control precautions and PPE must be worn properly throughout the day
- if the staff member works with patients or residents who are especially vulnerable to COVID-19 (as determined by the organisation), a risk assessment should be undertaken, and consideration given to redeployment for the remainder of the 10 day isolation period
Any staff admitted to hospital with COVID-19 symptoms will be subject to the guidance for isolation for patients within guidance for stepdown of infection control precautions and discharging COVID-19 patients.
UPDATED DHSC Guidance
COVID-19: management of staff and exposed patients or residents in health and social care settings
Updated 22 December 2021
Workforce Recruitment & Retention Fund Round 2 – Key points
On 16th December, the guidance on the £300 million Workforce Recruitment and Retention fund was published. This aims to provide urgent support for care providers to alleviate workforce pressures. The conditions of the grant state that the money must be spent by 31 March, and the grant is to be paid in 2 instalments, the first in January and the second in February. The grant allocations can be found here. We sent you some information about this on friday, but we have had a look at the guidance and have produced a summary of some of the key points.
The main purpose of the Workforce Recruitment and Retention Fund, Round 2, is to support local authorities to urgently address adult social care workforce capacity pressures in their geographical area through recruitment and retention activity this winter. It builds on the first round of this funding but has one key difference: it can be used to support payments to boost the hours provided by the existing workforce – including childcare costs and overtime payments.
Do note that the guidance says: unlike round 1 of the Workforce Recruitment and Retention Fund, the second round of the fund can be used for bringing forward planned uplifts relating to pay in advance of the new financial year. However, it should be noted that the fund is time limited between 10 December 2021 and 31 March 2022 and any ongoing burden would be incurred at risk.
Round 2 guidance also points specifically to the issue of workforce capacity issues & hospital discharge delays: Noting the link between adult social care workforce capacity and hospital discharge, local authorities should engage with CCGs and NHS trusts to work collaboratively to address workforce pressures which in some areas are delaying people from returning to their home from hospital.
Like Round 1 of the WR&RF, the money should be used to support the full range of social care providers, regardless of whether the local authority already commissions care from them and LAs are encouraged to passport the money directly and speedily to social care providers. This guidance for round two says:
‘To ensure maximum productivity of any payments to providers, local authorities should be mindful of ensuring money is available to support the sector quickly. Therefore, if a local authority chooses to make payments to providers, they should endeavour to passport funds as early as possible to ensure that providers have time to use the resources to maximum effect.’
‘If a local authority chooses to make payments to providers financed by this grant, it must ensure those providers will use the funding within the grant period to support new expenditure that retains existing workforce capacity or delivers additional staff capacity, and which has not already been funded by the Infection Control Fund or other sources of public funding. In addition, care providers should keep sufficient records to be able to demonstrate what specific staffing capacity was secured using this funding. Further information can be found in the ‘Financial management and the risk of fraud’ section of this guidance.’
Another condition of passported funding is to complete the Capacity Tracker at least once a week:
‘If passporting funds, the local authority should work constructively and collaboratively with providers receiving those funds to ensure that it imposes conditions on the provider requiring that they commit to completing the capacity tracker at least once per week until the conclusion of the fund.’
There are reporting requirements for LAs on Round 2 of the WR&RF (Jan 2022 & April 2022) and of course, this, in turn, means that LAS who do passport the funds directly to care providers will need to put in place due diligence reporting requirements from those care providers.
CQC – Supporting visiting over the festive season
The CQC have shared a message on visiting to help people understand the approach they’ve been taking on visiting during the pandemic and how they will continue to support providers to follow the most up to date government guidance. They have also been collecting feedback on visiting and following up with providers where concerns have been raised. This will continue to be their approach using risk-based targeted or focused inspections and utilising their ongoing monitoring approach. Throughout their communications on visiting the CQC have been clear that blanket approaches are unacceptable, this has not changed and where they are made aware of blanket bans, they will investigate and take regulatory action if required.
Through their inspection and monitoring activity, the CQC will be looking for you to demonstrate how you’re following the latest visiting guidance, with risk assessments to support your approach. It is also important that you share clear, transparent and regular communications with families and residents about visiting. They have expanded their Infection, Prevention and Control (IPC) inspections to gather information on visiting practices, and they will be increasing the number of IPC inspections in the coming months.
The CQC know that the majority of providers are making every effort to follow the latest guidance but if something changes and you’re unable to do this, please talk to your inspector, or contact their National Customer Service Centre so that they can ensure your query is picked up by an inspector.
DHSC: Adult social care workforce survey: December 2021 report
Published 17 December 2021
This report documents key findings from the responses collected from almost 9,000 adult social care settings in England through the workforce survey. This represents a response rate of 27% of all Care Quality Commission (CQC)-registered care homes and 44% of all CQC-registered domiciliary care providers.
Most respondents to the survey reported an increase in challenges in the 4 key areas of recruiting staff, retaining staff, morale and accessing agency staff, over the last 6 months.
CQC Statement – Festive Season Visiting (17/12/21)
Please see statement on our website on supporting visiting over the festive season. We’ll be following this statement up with a message to providers in our adult social care provider bulletin today, that will raise awareness of the updated visiting guidance and encourage them to contact us if they have concerns about decisions and risks relating to visiting.
Provisional Local Government Finance Settlement
Over £1bn of additional funding is being made available for children and adults’ social care:
- £700m of new grant funding for social care:
- £636m more into the Social Care Grant, including funding for equalisation against the 1% Adult Social Care precept
- Providing an inflationary uplift to support integrated working with the NHS
- Money for an improved Better Care Fund
- 1% Adult Social Care precept and deferred flexibilities from last year’s settlement
LAs are also able to access the un-ringfenced 2022/23 Services Grant (£822m) and Council Tax to raise money for social care in addition to the above. In terms of Council Tax, LAs are able to add up to an additional 3% of unused ASC precept from 2021/22.
Market Sustainability and Fair Cost of Care Fund: 2022 to 2023
On top of the above, the government has published a document which sets out how the government will provide £1.4bn (which is part of the £5.4bn Health and Care Levy) over the next three years to support LAs to prepare markets for reform and moving towards paying providers a fair cost of care. This is broken down:
- £162m for 2022-23
- £600m for 2023-24
- £600m for 2024-25
The document recognises that:
‘significant number of local authorities are paying residential and domiciliary care providers less than it costs to deliver the care received. This is undermining their markets, creating unfairness, affecting sustainability and, at times, leading to poorer quality outcomes.’
In preparation for the expanded means test and cap on care costs, DHSC wants to:
“address the current differential in fee rates charged to some self-funders. The market effect of this change will be that some providers will over time need to reduce reliance on subsidising state-funded care from self-funders.”
As part of this DHSC is enabling 18(3) of the Care Act (2014) to allow more people who self-fund care to ask the LA to arrange it on their behalf to secure better value.
Secondly, DHSC recognises that:
“uncertainty over future funding, combined with low fees by some local authorities, has resulted in under-investment in local care markets, buildings and innovation, and call-cramming (systematically cutting visits short to allow time for travel) in domiciliary care.”
LAs are expected to carry out the following activities:
- conduct a cost of care exercise to determine the sustainable rates and identify how close they are to it
- engage with local providers to improve data on operational costs and number of self-funders to better understand the impact of reform on the local market (particularly the 65+ residential care market, but also additional pressures to domiciliary care)
- strengthen capacity to plan for, and execute, greater market oversight (as a result of increased section 18(3) on commissioning) and improved market management to ensure markets are well positioned to deliver on our reform ambitions
- use this additional funding to genuinely increase fee rates, as appropriate to local circumstances.
As a condition of receiving further grant funding in the 2 following years, local authorities will need to submit to the Department of Health and Social Care (DHSC):
- a cost of care exercise – produced by surveying local providers for 65+ residential and nursing care and 18+ homecare to determine a sustainable fee rate for different care settings. Exercises will need to accurately reflect local costs such as staff pay and travel time, and provide for an appropriate return on capital or return on operations. Local authorities will be expected to publish the exercises
- a provisional market sustainability plan setting out local strategy for the next 3 years (2022 to 2025) – using the cost of care exercise as a key input, this provisional plan will demonstrate the pace at which local authorities intend to move towards a sustainable fee rate, in particular taking account of the impact of section 18(3) as well as other pressures they have identified. DHSC expects to see strategic planning for changes in types of provision in response to local need with other local areas, taking into consideration the role of new models of care (including housing)
- spend report – this will detail how money has been allocated in line with DHSC’s expectations in order to achieve a more sustainable local market
In short, it is positive to see a clear narrative from the Minister which recognises that the move to a fair price to care is an essential part of the reform to social care and a clear acknowledgement that ‘a significant number of local authorities are paying residential and domiciliary care providers less than it costs to deliver the care received.’ A fair price for care is a key ask in our Reform Ambitions published last May. However, we need to ensure that the fair price for care cost exercises are open and transparent in which LAs work with providers to reach honest and mutual agreement.
We are also concerned at how little money there is to make this vision a reality – a concern we expressed about the wider Adult Social Care Reform White Paper. It is hard to understand how the DHSC’s estimate of 1.4m can possibly meet the ambitions in in this statement. Other estimates have been closer to £7bn a year.
More detail is also need on how the DHSC views the likely progress of individuals in their ability to exercise their requests under section 18.3 of the Care Act; the ambition to enable more people who fund their own care to ask their local authority to arrange care on their behalf to secure better value rests, fundamentally, on local authorities’ ability to pay a fair price for that care. Failure to do so will result in huge market instability and the closure of many services as they become financially unsustainable. You can read our full response here.
In case you missed it, new antiviral treatments are being made available to eligible people in most care settings. There are two routes to accessing new COVID-19 treatments:
- Via a national study;
- Direct access to these treatments for those at highest risk of becoming seriously ill from COVID-19
Please see the following links for more information:
Liberty Protection Safeguards (LPS)
Please find attached an update on the implementation of the LPS from the Steering Group responsible. They plan to launch a consultation on the draft Code of Practice and draft regulations for LPS and the Mental Capacity Act early in the New Year. The letter also states that LPS will not be launched in April 2022.
Pregnant women and vaccination
The JCVI is calling on all pregnant women to get vaccinated as soon as possible due to the risk of COVID. The vast majority of pregnant women admitted to hospital with COVID-19 are unvaccinated.
Letter from Housing Minister on ventilation guidance for social and private landlords and residents
This comes a little late but the Housing Minister, Christopher Pincher, has written to all LAs in England summarising ventilation guidance in response to COVID-19. Landlords are being asked to:
- Ensure that all habitable rooms have functioning openable windows
- Ensure that all bathrooms/kitchens have either functioning openable windows and/or appropriate functioning extract ventilation
- Consider installing positive pressure or constant run ventilation systems to ensure there is adequate background ventilation and to reduce the likelihood of condensation, and ensure that such systems are operating effectively, with filters etc replaced at appropriate intervals
- Ensure that tenants have clear instructions and understand how to operate ventilation and heating systems, and are advised on the best ways to achieve a healthy and economic balance of heating, ventilation and moisture production within the home
- Ensure that problems with damp are fully investigated and addressed promptly
Survey about PA recruitment and retention
TLAP and LGA are running a survey to understand recruitment and retention amongst Personal Assistants. The survey can be accessed using this link and will close on 23.1.22. For those that might find the survey too challenging, there are two webinars that can be joined to have a conversation instead to discuss the challenges people are facing in recruiting and retaining PAs:
Update to management of staff and exposed patients or residents in health and social care settings
This guidance has been updated and is now in line with what was published in the visiting guidance last night. Self-isolation requirements have been removed for fully vaccinated contacts of a case infected with the Omicron variant and they should instead take daily tests. The majority of fully vaccinated health and social care staff will be able to continue in their usual role, providing:
- the staff member should not have any COVID-19 symptoms
- the staff member should not have any travel related isolation requirements
- the staff member should immediately arrange for a PCR test, either through their workplace arrangements or via the NHS Test and Trace service, and the result of this PCR test should be negative prior to returning to work
- following the negative PCR result, the staff member should undertake an LFD antigen test every day for the 10 days following their last contact with the case (even on days they are not at work)
- if a staff member has had a SARS-CoV-2 infection in the past 90 days, they should not have a PCR test and should only undertake daily LFD antigen tests
- on days the staff member is working, the LFD antigen test should be taken before starting their shift, and the result should be negative
- the staff member should comply with all relevant infection control precautions and PPE should be worn properly throughout the day
- if the staff member works with patients or residents who are highly vulnerable to COVID-19 (as determined by the organisation), a risk assessment should be undertaken, and consideration given to redeployment during their 10 day self-isolation period
If the staff member is partially vaccination or unvaccinated, they must self-isolate unless they are exempt (because they are under 18, unable to be vaccinated due to medical reasons or are taking part or have taken part in a clinical trial for a COVID-19 vaccine). If exempt, they should not attend work, or be redeployed to another role for the period of what would have been the isolation period.
Do note that if a staff member is providing care to or is in close contact with an individual with a COVID-19 infection and is wearing the correct PPE appropriately in accordance with the UK IPC guidance and How to work safely guidance, they will not be considered as a contact for the purposes of contact tracing and isolation, regardless of vaccination status.
In the case of residents who have been exposed to a confirmed COVID-19 case, they should be isolated or cohorted for 14 full days after their last exposure. Do note that asymptomatic and fully vaccinated residents will not require self-isolation if certain additional mitigations are in place. Refer to the guidance on admission and care of residents in a care home during COVID-19 for further information but be aware that that piece of guidance is awaiting an update.
Migration Advisory Committee (MAC) Annual Report
The MAC has published its Annual Report and used it to advise the government that it should immediately add care workers to the shortage occupation list and Health and Care Visa:
‘We are currently in the middle of a commission investigating the impact of the ending of freedom of movement on the adult social care sector. We provide an update in this report on our preliminary findings and unusually are taking the opportunity to make a formal recommendation to the Government. Given the severe and increasing difficulties the sector is facing in terms of both recruitment and retention, we are recommending that care worker jobs immediately be made eligible for the Health and Care Visa and placed on the Shortage Occupation List. We will be producing the final report in April 2022.’
This recommendation needs to be accepted by the Home Office to become reality. This is something NCF has been asking for, even before the pandemic.
DHSC Update – visiting query
It is important that the nominated visitors remain the same people, as far as possible. This is important in reducing the risk of transmission, by limiting the number of different people coming into the care home from the community. However, we recognise that there will be situations in which a nominated visitor cannot continue to visit (for example because of illness). We advise care homes and families to take a pragmatic approach, with the aim of minimising change wherever possible.
Dec 15th 21.
Presentations and contact details from the Registered Manager V-Meeting Dec. 15th 10.00 – 11.30
Updating your Contingency Planning Process & bringing your Staff Development & Training Matrix up to date.
Skills for Care – Selena Docherty Contingency Planning
Social Works contacts
020 7277 9117
Skills for Care Endorsed Training Provider. Much of the training is covered by Workforce Development Funding – Course update
SLaM – Hannah Wilson & Anna Cooke, with an update on the Keeping Well portals pan-London and Women’s Issues
Keeping Well Portals across London
Update to visiting guidance in light of Omicron
The guidance outlining visiting arrangements in care homes has been updated again ahead of it going live tomorrow. This is to reflect Omicron impact and the restrictions announced at the weekend. The guidance uses the same structure outlined in the previous version with the addition of restrictions:
- Section 1 is ‘Visits in all Circumstances’ which makes the guidance around end-of-life visits and essential care giving more prominent in the guidance. There is also a section in here on visiting professionals, including requirements for VCOD and testing.
- Section 2 is focused on safe visiting practices such as IPC measures, risk assessments, testing arrangements, visits out of care homes, communications with families and visitors
- Section 3 is focused on when alternative visiting arrangements might be required and looks at care home outbreaks and the role of Public Health and DASSs
- Section 4 contains information of other sources of support and information – including our Partners in Care resource
The key things that have changed since the last version issued a few weeks ago are listed below but note that some of these changes pre-empt other pieces of guidance (on testing and isolation specifically) which have not themselves been updated. Go with what is written in the guidance:
- every care home resident can nominate up to 3 visitors who will be able to enter the care home for regular visits (this number does not include essential care givers or preschool age children)
- since September 2021, if no further positives are identified in the 2 rounds of whole home outbreak testing, subject to the HPT risk assessment, then the outbreak restrictions can be lifted. This could mean that outbreak restrictions are only in place for 7 to 8 days in some outbreaks. However, outbreak controls may be in place for up to 28 days following the last positive case due to Omicron variant. This appears to be a decision for the local HPT.
- anyone who is fully vaccinated, and has been identified as a close contact of a confirmed case of the Omicron variant of COVID-19, does not need to self-isolate if they receive a negative PCR test result and take daily rapid lateral flow tests until 10 days after their last exposure to the positive case. We asked for clarity on this point as it differs from the 7 days mentioned in other communications today. DHSC has told us that 10 days is the correct number.
- the esting regime has changed for staff and essential care givers: 3 LFTs a week + PCR test. Essential care givers are also subject to rapid response daily testing in the event of an outbreak
- Care home residents who have had 2 doses of the vaccine, or are exempt from vaccination, should not have to isolate for 14 days after most visits out of the care home, but should take a lateral flow test every day for 10 days following the visit out. This does not apply in the case of an emergency stay in hospital or visits deemed to be high-risk following an individual risk assessment. In these instances isolation for 14 days is required.
- Care home residents who have not received at least 2 doses of the vaccine, and are not exempt from vaccination, should not go on visits out of the care home unless they isolate for 14 days after the visit out. DHSC states that this ‘is a necessary precaution following clinical advice in light of a more transmissive variant of COVID-19’
- There is an increased emphasis on the importance of boosters
You may already have spotted some conflicts in the above around isolation, vaccination and medical exemptions. There is a tension that the guidance suggests that people who are exempt from vaccination are able to go on visits out while those unvaccinated cannot. Similarly, it is unclear if someone who is medically exempt but a contact of a Omicron case is expected to isolate or not. We are seeking clarification from DHSC/UKHSA.
Other than the above much of the guidance remains the same as the previous iteration. The focus is still on enabling visits to happen.
Please also continue to note:
- Enabling visiting should remain default position – even during outbreaks with some caveats (see section 1.1, 1.2 & 3).
- Visiting is still allowed in a resident’s room where this would benefit them
- Facemasks can be removed in certain circumstances when not in communal areas of the home but other mitigations should be put in place to compensate – see the guidance
- Visitors are advised not to visit if they are a contact of a positive case:
- ‘visitors who are not legally required to self-isolate are advised against visiting the care home (for 10 days) if they have been identified as a close contact of someone with COVID-19, unless absolutely necessary, even if they have been fully vaccinated. Where visits do occur, visitors should have received a negative PCR test result prior to their visit, and a negative lateral flow test result earlier in the day of their visit’
- Physical contact should be supported to help health and wellbeing as long as IPC measures are in place
- There is an increased focus on the flu and COVID-19 vaccines as well as other respiratory viruses such as RSV
- The section on visiting professionals makes it very clear that they need to show evidence of vaccination or exemption alongside a negative test (taken within 72 hours) to enter the care home.
The health and social care workforce is predominantly made up of women, and yet we know that workplaces aren’t always designed with women in mind. Keeping Well in South East London has lots of resources relating to issues that, in the main, affect women.
Going through the menopause can feel daunting, but the page on menopause and peri-menopause has some great information about the changes women might go through, including women speaking about their own experiences in a video series. Creating menopause-friendly workplaces is important to help take away stigma and make sure women feel supported at work, so there are also some tips for managers.
When it comes to children and families, the pandemic has put extra pressures on already stretched parents. It’s important to take care of yourself in order to take care of your children, so why not have a look at the site’s advice on keeping yourself well if you need a helping hand.
Women are sadly more at risk of suffering from domestic abuse and sexual violence, for example, so if reading about keeping yourself safe might be helpful, you can look at the page on violence against women and girls. The National Domestic Abuse Helpline is a 24-hour resource if you are concerned about your own safety or the safety of someone you know.
The Keeping Well site features lots of other self-help resources to help women manage issues affecting them, both at work and at home, so head over to the Women’s issues pages to find out more!
NAVIGATING THE IMMIGRATION SYSTEM
IN THE CARE SECTOR
Yet another Friday evening DHSC Briefing
‘Support Package’ for Adult Social Care
Last night DHSC issued a press release outlining a package of measures designed to protect the social care sector from Omicron. Please also see the attached letter from the Minister for Care. Infections of the Omicron variant are currently doubling every 2 to 3 days.
- An additional £300m to the £162.5m workforce and retention fund. This money can be used to pay for bonuses and bring forward pay rises for care staff, fund overtime and staff bank increasing workforce numbers until the end of March.
- Visiting guidance will be updated to restrict visiting to 3 nominated visitors and an essential care giver per resident.
- Staff testing will increase from 2 lateral flow tests per week to 3 as well as a weekly PCR test
- Fully vaccinated residents visiting out will be asked to take a lateral flow test on alternate days for 2 weeks after a visit. Those not fully vaccinated will be expected to isolate following a visit out
- Extra guidance will be given for IPC and PPE.
- Recognition that the booster programme needs to reach the most vulnerable members of our society and care workforce. DHSC guarantees that any homes that have not yet received a visit will be prioritised. Homes will get more than one visit.
- NHS is closely monitoring the data on vaccination team visits to care homes and housebound people.
- Social care workers can continue to book a booster via the National Booking Service and should book if it is 2 months since their second dose. They will be able to receive the booster once 3 months have passed.
Workforce recruitment and retention fund: examples of allowable activity
The guidance on the workforce recruitment and retention fund has been updated to include examples of activities that have been used by LAs and providers.
Home Office Webinar – Social Care: Points-Based Immigration System Update
The Home Office is running a webinar on 13.12.21 10am-11am to give an overview of the points-based immigration system for the Social Care sector. It will include updates on:
- Skilled Worker visa
- How to become a Home Office sponsor
- Other Immigration Routes
- Right to Work checks
- EU Settlement Scheme
- Support available
Plan B Announcement
This evening the PM announced that England is now moving to Plan B of the Winter Plan. This means:
- People should work from home where they can from Monday
- From Friday, face masks are mandatory in most indoor venues but not when eating, drinking, exercising or singing
- Vaccine passports will be required for visitors to nightclubs, indoor seated venues with more than 500 people, unseated outdoor venues with more than 4,000 people and any venue with more than 10,000 people. LFTs can be used to prove entry.
He also stated that the government plans to introduce daily tests for contacts of Omicron instead of isolation – we will be seeking clarity on this and whether this applies to social care. This is currently not what guidance states. We will keep the membership updated as we receive more information.
VCOD Medical Self-Exemption Update
Believe it or not but DHSC has extended the self-exemption deadline again. See the attached letter and this link. Self-certification forms will continue to be valid until 31 March 2022 for self-certified medical exemptions, so long as they have been received before 24 December 2021.
The reason for this extension is because some people who have applied for a formal exemption have experienced a delay in the outcome of their application being notified.
Please note that self-exemptions for people vaccinated overseas continue to be accepted until 1 April 2022 as well. Please also see the Q&A in the VCOD stakeholder toolkit
Timeline for VCOD in wider health and social care settings
DHSC have provided a rough timeline for the implementation of the wider policy in non-care home settings:
- December – Votes in the Commons and Lords on VCOD in wider health and care settings
- December – Stakeholder engagement on operational guidance (we can confirm this has begun)
- Early January – Start of grace period
- Early January – Operational guidance issued
- 4 February – Last date for first vaccine (8 weeks before regulations come into force)
- 1 April – Regulations come into force
We’re aware that when the regulations are passed by parliament, the amendments relating to the care home regulations should go live at that point and not in April – we are looking for clarification on this point and will update members when we have it. The rough timeline provided by DHSC doesn’t state this.
DHSC has announced a national study for COVID-19 antivirals for over 50s and those with underlying health conditions. We will circulate more information about what this looks like for social care when we have it.
DHSC UPDATE Dec. 6th 2021.
I am emailing with regards to the announcements made last week with regards to the Omicron variant and the subsequent updates to the vaccination programme. We have received several queries on how this might affect guidance for the care sector, so I’m sending this email to confirm the position.
Throughout the pandemic our guidance has been kept under review in line with the latest clinical advice and this remains the case. The published guidance on home care, care home admissions and visiting and infection prevention and control measures continue to reflect the latest position and should continue to be followed unless advised otherwise. We urge providers to continue to stay in touch with their local protection teams and follow the guidance on self-isolation for confirmed cases of the Omicron variant.
Please also find here the social care winter vaccinations comms toolkit. This communications toolkit is designed to support communicators with running their own winter vaccinations campaign to encourage staff to get the flu vaccine and COVID-19 booster.
Stepdown of infection control precautions and discharging patients to home settings
This guidance has been updated to reflect guidance around isolation if a contact of a confirmed or suspected Omicron variant of COVID-19. See the section ‘Discharging COVID-19 patients to a single occupancy room in a care facility, including nursing homes, residential homes and designated settings’.
Management of staff and exposed patients and residents in health and social care settings
This guidance has been updated to reflect the Omicron variant. See sections 2.5.1, 2.5.2, 3.1, 3.2 and 4.1. In short:
- Staff members who are a contact of Omicron case must isolate for 10 days even if they are double vaccinated.
- Residents who are known to have been exposed to a confirmed COVID-19 case should be isolated or cohorted for 14 full days after their last exposure to a COVID-19 case. If they are cohorted, this should only be with other residents who do not have COVID-19 symptoms but who have also been exposed to a confirmed COVID-19 case. This also applies to residents who have previously recovered from COVID-19. Residents who have been exposed to a suspected or confirmed case of Omicron variant SARS-CoV-2, should be isolated separately.
- Asymptomatic and fully vaccinated residents will not require self-isolation if certain additional mitigations are in place, unless they are identified as a contact of a suspected or confirmed case of the Omicron variant
- Staff and residents who have previously tested positive within 90 days but have since become a contact of Omicron are no longer exempt from testing.
WHITE PAPER (at last)
I am delighted to inform you that the Adult Social Care White Paper – People at the Heart of Care – has been published. This is accompanied by a letter to the sector from the Minister for Care, Gillian Keegan, please find this attached. The Minister is currently delivering an oral statement in the House, you can watch this on Parliament TV.
The White Paper sets out a new programme of improvements for adult social care and marks an important step towards a long-term vision for social care in England. The new measures aim to give greater choice, control and independence to individuals receiving care, as well as support for the workforce. Over £1.7 billion will be spent on these reforms, forming part of the £5.4 billion announced in September funded by a new UK-wide 1.25% Health and Social Care Levy from April 2022.
The package includes:
- At least £300m to help local authorities offer a wider variety of supported housing options to help individuals live as independently as possible.
- The digitalisation of social care to support people to live independently and improve their quality of care, backed by £150m of funding.
- A new professional development plan for the social care workforce and mental health and wellbeing resources funded with an investment at of least £500m.
- An additional £70m to improve and increase the range of care and support services.
- A new £30m Innovative Models of Care Programme to support local authorities to launch innovative new ways of delivering care in the community to improve the choice of care available to individuals.
- New pilots to understand how best to help people understand the care and support they need.
- And investing up to £25m to work with the sector to kickstart a change in services to support unpaid carers.
This system reform White Paper sits alongside changes to the way that people pay for their care, which was also announced by the Prime Minister in September. The amount people pay for personal care over their lifetime will be capped at £86,000, giving individuals and families greater certainty over how much they will pay for care. We will also be making the means test more generous and anyone with less than £20,000 in assets (compared to £23,350 under the current system) will not have to pay anything from their care from their assets. Anyone with assets between £20,000 and £100,000 will contribute towards their care but will be supported by the state. If somebody or their spouse lives in their home, their home is not counted as part of their assets.
I am also pleased to announce the launch of our new campaign website – Transforming Social Care. The objective of the campaign is to ensure the public understands the changes to social care and how they will impact them and their families. The dedicated campaign website on Gov.uk will act as a central hub of up to date information for the public and stakeholders on social care reform. It will feature key explainer content, information on the reforms, downloadable resources, and interactive tools for the public to use to navigate the social care system. The campaign website can evolve and we are very much open to feedback and suggestions for how to improve it, so if you have suggestions, or perhaps case studies that we could feature, please do let us know. A huge thanks to colleagues who have already provided case studies. We hope that you will support our campaign and promote it through your communications channels.
GLA Funding – Do you support Women Returners?
Successful Mums Career Academy have secured funding from the Mayor of London to work with a number of forward-thinking employers. The funding is aimed at Care employers that encourage flexibility and diversity by including parents into their future workforce.
This means Successful Mums can provide employers with FREE advertising on their job board along with practical, short online training sessions covering;
- Introduction to flexible working
- Flexible working in practice
- Managing a flexible workforce
- Attracting skilled women to your workforce- how to advertise and attract talented mums
- Women’s health and wellbeing
Plus, policy templates for your adaptation;
- Women’s health and menopause
- Flexible working
- Equal opportunities
…and guidance on quality standards accreditation for your company to embrace flexible working and stand out as an employer of choice.
By signing up, you will also receive free advertising on our job board to reach out to our skilled audience of women for up to two years, plus PR opportunities as a forward thinking employer.
Taking part is completely free and just requires a few hours of your time and an interest in implementing flexible working practices in your workplace.
“Free webinar – Weds 1 December at 12pm – Citation will be outlining your employer responsibilities with regards to the use of personal vehicles for work purposes and how to manage driver safety in your business”
Adopting a Vat Strategy for GROWTH
Businesses could save thousands in new government digital support scheme
Small businesses could get up to £5000 towards the cost of buying new digital software to help boost their business growth.
From December, the government’s new Help to Grow: Digital programme, will give free and impartial advice to businesses on how digital software can help them grow and reach their full potential.
The support for eligible small businesses provides vouchers worth up to 50% (up to £5,000) off the cost of approved software from a range of approved leading technology suppliers.
To register interest in the scheme, visit Help to Grow
Updates to Discharge Guidance Leaflets
A series of leaflets have been updated relating to discharge:
- Looking after friends or family when they leave hospital
- Hospital discharge leaflet for patients entering hospital
- You are leaving hospital – returning home
- You are leaving hospital to go to another place of care
Update to supported living services
This guidance was updated earlier this week in line with the latest advice from UKHSA. The summary of changes note at the top of the page outlines what has changed. Changes include advice on staff moving between care settings, visiting and discharge from hospital. On that last point, the guidance now states that supported living settings that ‘are comparable to care homes should refer to the admissions guidance for advice on self-isolation following an unplanned admission’.
Infection Prevention and Control Good Practice Guide
Skills for Care has published a guide outlining good practice examples for care home and home care workers, and for infection control teams. It has a preamble from Professor Deborah Sturdy.
Updates on recently published guidance:
- The IPC Good Practice Guidance was published on Thursday 18/11. Access here – Good Practice Guide Nov 2021 (skillsforcare.org.uk)
- Guidance for Supported Living updated on Monday 22/11. Access here – COVID-19: guidance for supported living – GOV.UK (www.gov.uk)
- Providing Unpaid Care guidance updated today 23/11. Access here – Coronavirus (COVID-19): providing unpaid care – GOV.UK (www.gov.uk)
- Restricting workforce movement between care homes and other care settings updated today 23/11. Access here – Restricting workforce movement between care homes and other care settings – GOV.UK (www.gov.uk)
Wellbeing Champions Training Dec. 8th 12.00pm.
CQC – Getting Inspection Ready & Building Organisational Culture – Nov 17th
From Mick Feather of Citation
From SfC’s Laura Anthony & Selena Docherty
From Hannah Wilson of SLaM
Keeping Well London event Nov 25th
Bringing Social Care, Community & Healthcare together.
With Dudley Sawyerr, Patience Mukosa, Anoushka Farouk and Michael Mahy
Important free care webinars – mandatory vaccinations (updated guidance) and culturally appropriate care
Social Works Funded Training Courses and Dates
Keeping Well Portals for London
Care Home Guidance with Ambulance Crews.
We do not have the exact one for all London areas, this will act a as guide. If you have local ones, please share with us.
Please find attached DHSC weekly Stakeholders Q&A.
Some key themes highlighted in the document include:
- Secretary of State, Sajid Javid on Covid-19 and winter illnesses
- Government to introduce COVID-19 vaccination as a condition of deployment for all frontline health and social care workers
We will continue to add short clips from announcements along with graphics, visuals and further videos.
Further resources including social content are available on PHE’s campaign resource centre.
Please let us know how you have used the resources and how they can be improved.
We would like to signpost you again to some useful links:
- Vaccine Uptake Plan
- Vaccine Delivery Plan
- Latest vaccination data
- Bristol University ’Global experts urge everyone to talk about COVID-19 vaccines responsibly’
- Covid-19 PHE The Green Book – updated with new advice on pregnancy
- Action fraud
- NHS Covid vaccine
- Pregnancy and fertility Q&A
- Employers Toolkit
- NHSEI toolkit for promoting vaccine take up among Black African and Black Caribbean communities: link
- Parents FAQ on vaccinating 12-15 year olds
Following the government announcement stating that the COVID-19 vaccine will become compulsory for care home workers or volunteers as of 11th November 2021, the Department for Health and Social Care has released a stakeholder toolkit. The toolkit offers guidance to those affected by this new regulation and breaks down what it will mean for them going forward.
Find out more
Digital Social Care have published with a disclaimer.
UPDATED – CQC and DHSC vaccination lead have confirmed that care homes only need to record who came in on what date and the fact that they have checked the vaccination status. There is no need to record any further details.
Being Black in #socialcare beyond October.
Hear the interview from Dudley Sawyerr and respected black colleagues,
Victoria Oladosu CMgr-MCMI MIHSCM,
Deanna Berry and
Social care, which has one of the largest black workforces in the UK, being represented and heard beyond #blackhistorymonth in October is very important. To hear this insightful and thought-provoking discussion please click on the link below and feel free to share.
Watch the video: https://lnkd.in/dbhdes3T
Free Guide to Infection Control
Implementing the Home First Discharge
Following the consultation: Making vaccination a condition of deployment in the health and wider social care sector;
the vaccination as a condition of deployment (VCOD) policy will now be extended to all health and care staff. The Secretary of State has just announced this in the House.
- Staff working face to face with patients or service users will need to be vaccinated against Covid-19 in order to be deployed, unless they are exempt.
- Covid-19 boosters and flu vaccinations are not included in the policy scope.
- Once the regulations have been laid and approved in Parliament, there will be a 12-week grace period before the regulations come into force. Therefore, the policy is expected to come into force in April 2022.
Additional information can be found in the below press notice. Further details can be found in the consultation response, published here
This policy does not supersede, but sits alongside, the previously announced regulations requiring anyone working in a CQC-regulated care home to be vaccinated by Thursday 11 November. The operational guidance for this policy can be found here. The regulations that introduce VCOD across health and wider social care settings will include some amendments to the existing care home regulations. Once approved by Parliament, these amendments will take effect in the coming months:
- An unvaccinated new starter can be deployed in a care home 21 days after receiving one dose of an authorised COVID-19 vaccine
- Staff vaccinated overseas can be deployed but may need to receive a top-up vaccine dose, as per UKHSA advice. The government intends to run the self-certification process for people vaccinated in care homes until the end of the proposed grace period which is expected to be 1 April.
- Clinical trial participants will need to evidence their participation in order to be exempt from the requirement
- The definition of authorised vaccine will be aligned across the two policies
Please find here our stakeholder toolkit, including posters, social media assets and Q&As, which we will continue to update over the coming days. If you have any questions, do not hesitate to get in touch, and if you could forward me any comms your organisation puts out on this, I would be very grateful.
Providing Home Care
This guidance has been updated to reflect the latest advice from UKHSA (formerly PHE). This is separate from the PPE guidance. The summary table at the top of the main guidance page outlines what has changed. The updates largely bring this piece of guidance in line with other pieces of guidance.
Invitation to participate in research on Covid-19 impacts on care home staff
This is a really useful, short and anonymous survey, please help your sector by completing. Thanks.
We are inviting you to answer a short survey on how Covid-19 has affected care homes and their staff. The survey is focused on your experiences of working in a care home during the pandemic.
Your perspectives will help decision-makers in government and employers to understand what funding and support are needed by care homes and their staff.
The study will inform policy and practice with the academic outputs being shared with all stakeholders. Therefore, your input can make a real difference to how we deliver these services in the future.
The survey will take about 10 minutes. It is up to you if you take part. You will not be asked for your name or the name of your workplace in the survey.
10 people who answer the survey will win a £50 shopping voucher.
This research is led by Professor Marianna Fotaki (University of Warwick) and her team, with public funding. NCF and UNISON are supporting this valuable research.
The Adult Social Care Winter Plan
Has been published & can be found here. Please also find attached a letter to care colleagues from our Minister, Gillian Keegan, outlining what is in the plan
Are you able to spot Workplace Stress?
The first week of November marks Stress Awareness Week, which aims to increase the awareness of the causes and signs of stress, including within the workplace. With 11 million working days lost to stress each year*, it’s your legal duty as an employer to take steps to protect your employees from stress at work.
Stress can impact anyone, regardless of skill, experience, age, or disability – are you confident you can spot the signs and mitigate the risks to your people and your business?
To help you support your employees and stay on the right side of the law, the Health & Safety experts of our Citation, have put together an exclusive guide on stress risk assessments – including how to recognise the signs of stress and assess the risks involved.
Your member benefit
As an employer, you’ve got a lot of responsibilities. But don’t worry, Citation is here to help! If you sign up with them, they’ll help you meet your compliance goals with their bespoke HR and Health & Safety handbooks and policies, access to 24/7 advice and much more.
If you’d like to chat about how Citation can help with the HR and Health & Safety side of your business, just give them a call on 0345 844 1111, or fill in their call-back form and they’ll get right back to you.
Please quote the association (s) you are a member of when enquiring to access your member benefit.
Adopting Digital Social Care Records – Masterclasses
During 2021-2022, Digital Social Care are partnering with NHSX to run a masterclass series for adult social care providers. The series will bring together sector experts, technology companies and care providers to share their experiences in choosing and using digital care records.
You can access recordings of the following sessions which have already taken place:
Find out more and book a place at future masterclasses.
Home Care Cost of Care Tool: Demonstration and Discussion Webinar 16 November, 10-11am
A free Cost of Care Tool for home care has been commissioned by ADASS and LGA, and developed by ARCC Ltd. The tool is now being shown to councils, care providers and other partners across the sector. The attached slides give an overview of the purpose and function of the tool and next steps. A webinar has been arranged to demonstrate the tool, show how it works and answer any questions. This is for providers only and takes place on Tuesday 16th November from 10.00 – 11.00. Please register to attend.
We have asked to see the underlying assumptions for this new model and will also attempt to arrange a members’ session with the developers of the tool, ADASS and LGA.
COVID-19 Booster Vaccine Guidance Updated
The clinical guidance has been updated to allow COVID-19 boosters to be given earlier than 6-months to those at highest risk where this makes operational sense. One example in the press release is that of care home residents who may have received second doses at different times. This guidance would allow all those residents to be vaccinated at the same time, as long as it has been 5-months since their second dose. The Green Book Chapter 14a has been updated to reflect the change.
The DHSC has written a letter to visiting professionals which (alongside a range of other materials) can be found on Skills for Care’s vaccination resource page. We have also added two items to the stakeholder toolkit – a social media graphic (which we will be posting on DHSC channels soon) and a poster for care homes to display, as below.
DWP update on Universal Credit
The Chancellor has delivered the Autumn Budget and Spending Review for 2021, setting out how we will level up opportunities as we build back better from the pandemic. In this he has stated that the taper rate in UC will be increasing,
Cut to the Universal Credit taper rate, and Universal Credit Work Allowance increased
The taper rate means that if people increase their earnings, by working more hours for example, their Universal Credit is gradually reduced. The current taper rate is 63p, meaning for every £1 a person earns after tax, their Universal Credit is reduced by 63p.
The Chancellor announced that the Government is cutting the taper rate by 8p, from 63p to 55p, ensuring more money in people’s pockets.
The Work Allowance allows some households to earn a set amount before the taper rate kicks in. This is generally for households on Universal Credit who are in work and either looking after a child or have a household member with limited capability for work
Work Allowances are currently set at £293 a month if the household receives housing support, or £515 if they do not receive housing support. These are both being increased by £500 per year
Both of these changes will be implemented from December 2021, and together will benefit 1.9 million households who will on average keep around an extra £1,000 a year. The changes apply across Great Britain, and the Northern Ireland Executive will be funded to match them.
LCAS RM V-Meeting October 27th on Recruitment & Retention, presentations and recording
An area of major issue to social care providers. Here are some new and innovative suggestions to help you RECRUIT & RETAIN staff.
Thoughts Become Things Sue Jones. Sue has a successful track record, including with Home Instead, of helping organisations to innovatively recruit and retain staff in difficult circumstances.
The Values exercise referred to in the presentation can be accessed from the PDF above and the Employee Segmentation Template is below
Skills for Care’s Laura Anthony. SfC have a wealth of knowledge, support and tools for you to freely access to help you succeed with recruitment & retention.
Successful Mums Jane Knight. www.successfulmums.co.uk have community funding to work with a number of care employers that want to embrace flex working and women returners /parents into their workforce
Recording of the meeting
How to access the Workforce Development Fund to help fund and support your training – Dave Vincent – David@clarendonhomecare.com
From the DHSC Covid-19 Testing, PPE and Vaccines Division – MASK RECALL.
Please find attached information on recall of Obisk Blue Tree Face Type IIR mask – MKTIIR0214 (tie back) and MKTIIR0199 (ear looped). Batch/LOT numbers:
The MKTIIR0199 (ear loop) mask has been on the PPE portal and is likely to have been ordered by ASC and other providers. Communications will also be sent from the portal team, however we would appreciate it if you could please cascade this information to providers. If any providers have these masks, as detailed in the attachment they should inform the NHS Product Enquiries Team by emailing firstname.lastname@example.org , quoting Ref: Obisk Blue Tree Face Type IIR mask and confirm the volume of product in stock by 15/11/21.
Living Wage Implementation in Adult Social Care:
links to the Living Wage Toolkits.
The survey would help to calculate a realistic funding amount required from your local authority to enable your organisation to pay the LLW to your staff, a useful help to retain them. If you would like to complete the online survey, please go to https://www.tfaforms.com/4938772
Update to Hospital Discharge and Community Support: Policy and Operating Model
This guidance has been updated to reflect Q3 & Q4 funding.
The updates relate to the funding only; there are no policy changes. The following summary has been sent to us by the NHS Discharge to Assess team.
- The fund is to help cover the cost of up to 4 weeks of post-discharge recovery and support services for new or extended packages of care delivered on or before 31 March 2022
- The money also supports designated care settings for those discharged from acute care who are COVID-positive and cannot return directly to their own care home until they have undergone 14 days of isolation
- The confirmed allocations use a blended approach, which has regard to weighted population and reported spend on national discharge support
- The funding distribution mechanism will continue to follow the process used previously in that there will be a centrally held fund against which systems partners should claim expenditure (coordinated by CCGs / ICSs)
- Unlike previous funding arrangements, national funding is not available for care delivered after 31 March 2022, even where discharge takes place on or before that date. Systems should plan to provide continuity of care for people receiving post-discharge recovery and support services at the end of March 2022
- Systems should plan for discharge funding arrangements that are sustainable and affordable from core NHS and local authority expenditure from 1 April 2022
Update to VCOD Operational Guidance
The operational guidance for vaccination as a condition of deployment in care homes was updated yesterday to add information about exemption and vaccination abroad. There are a number of things to note:
- The self-exemption process for individuals vaccinated outside the UK continues until further notice beyond 24 December.
- Links to the temporary self-exemption process and formal process have been added throughout the guidance.
- NHSX is considering how the NHS COVID Pass service could be used to support registered persons and staff to check and demonstrate vaccination status. For the time being vaccination can be evidenced via the NHS app, the NHS website or the NHS COVID Pass letter. – we are not entirely sure what the distinction is between what NHSX is considering and the current process.
The DHSC would like to signpost you again to some useful Covid links:
- Vaccine Uptake Plan
- Vaccine Delivery Plan
- Latest vaccination data
- Bristol University ’Global experts urge everyone to talk about COVID-19 vaccines responsibly’
- Covid-19 PHE The Green Book – updated with new advice on pregnancy
- Action fraud
- NHS Covid vaccine
- Pregnancy and fertility Q&A
- Employers Toolkit
- NHSEI toolkit for promoting vaccine take up among Black African and Black Caribbean communities: link
- Parents FAQ on vaccinating 12-15 year olds
Registered Manager V-Meeting follow up. October 13th. Mental health & wellbeing
the presentations and recording (to be added shortly) of the meeting are now available
Hannah Wilson and Nadia Pantouw from SLaM. Please pass on the links to your staff, this portal is for all to use and gain from
There is also a Community Forum linked to this Follow this link to sign up. As part of this, it would be great if you are able to sign up, join in and comment. This helps to develop the forum and a portal that really meets the needs of users.
Laura Anthony SfC. The SfC website has an easy to navigate information list for staff health and wellbeing, it’s free and again has links useful to staff in organisations across social care, make these available to your colleagues.
David Vincent – Workforce Development Fund
This funding from the DHSC is a great route to supporting your staff training & development. An essential part of your organisational culture, your quality programmes and helping to motivate and retain staff.
To contact David – David@clarendonhomecare.com
Recording of the meeting
The next v-meeting is focussed on recruitment & retention with SfC, Sue Jones – Thoughts Become Things and Jane Knight from Successful Mums and it is on October 27th 10.00 – 11.30
Meeting ID: 862 5601 4697
One tap mobile
+442034815237,,86256014697#,,,,*552277# United Kingdom
+442034815240,,86256014697#,,,,*552277# United Kingdom
The latest edition of the Adult Social Care Update featuring:
- Vaccination as a condition of deployment (VCoD) – 11 November deadline less than a month away
- Consultations closing soon: ‘VCoD expansion beyond care homes’ and ‘free PPE extension’
- Winter vaccination campaign – blogs and resources
- Latest blogs: staff retention and ‘Why I’m having the COVID-19 booster’.
CPA Q&A on VCOD in care homes
The Care Provider Alliance has published an updated version of their Q&A on vaccination as a condition of deployment in care homes. It covers self-certification, medical exemptions and HR issues.
DHSC Webinar: COVID-19 Vaccination of People Deployed in Care Homes
DHSC is running a webinar on 20.10.21 from 9:30am which will talk through the medical exemptions process for VCOD. You can sign up here.
From SfC, a tool to support you in sourcing resources to help you help your staff and so aid retention and lower absence
A DHSC letter to support with the exemptions process.
The Standard Operating Procedure (SOP) for vaccination of frontline social care workers has now been updated to include boosters in Phase 3. You can access the SOP online
Keeping Well portals for London
For SE London, that is the boroughs of
Bexley, Bromley, Greenwich, Lambeth, Lewisham and Southwark.
For NW London, that is the boroughs of
Brent, Ealing, Hammersmith & Fulham, Harrow, Hillingdon, Hounslow, Kensington & Chelsea and Westminster.
For SW London, that is the boroughs of
Croydon, Kingston upon Thames, Merton, Richmond and Wandsworth.
For NE London, that is the boroughs of
Barking & Dagenham, City of London, Hackney, Havering, Newham, Redbridge, Tower Hamlets and Waltham Forest.
For NC London, that is the boroughs of
Barnet, Camden, Enfield, Haringey and Islington.
All offer free and confidential mental health and wellbeing support for you and your staff.
Updated Vaccination Standard Operating Procedures
Two Standard Operating Procedures for phase 3 booster vaccinations have been updated:
- The roving and mobile SOP, including a section on care homes in appendix A
- The SOP for vaccinating unpaid carers has been updated to help identify and enable unpaid carers to access priority COVID-19 booster vaccinations. It also encourages unpaid carers who may not already be identified by the health and social care system to make themselves known to their GP practices and Local Authority Carers Teams.
Vaccine clinical trial participants can now be offered an approved vaccine
DHSC has announced that people who were part of a clinical trial of a vaccine which is not yet approved in the UK will be able to access doses of an approved vaccine. This will initially benefit those who received the Novavax vaccine as part of their clinical trials. We don’t think there will be very many social care staff, if any, who will be impacted by this but this does give an indication of the direction the government might be willing to go in re vaccination as a condition of deployment for those vaccinated overseas.
Launch of the Office for Health Improvement and Disparities (OHID)
Health disparities across the UK will be tackled through a new approach to public health focused on stopping debilitating health conditions before they develop, as the Office for Health Improvement and Disparities (OHID) launched this week. OHID marks a distinct shift in focus at the heart of government in addressing the unacceptable health disparities that exist across the country to help people live longer, healthier, happier lives and reduce the pressure on the health and care system as work is done to reduce the backlog and put social care on a long-term sustainable footing.
The 2020 LeDer report
Free Government funded care home website and energy efficiency tool
Your residential care home can find:
- Effective energy efficiency improvements to make to your care homes
- Ways to fund and procure these improvements
- Trusted suppliers and contractors
- Current energy efficiency standards and regulations
This new tool can help you make savings on your care home’s energy bills and improve the residents’ comfort. Just visit https://www.bregroup.com/care-home-energy-efficiency, input simple information about your building/s to get a bespoke list of potential improvements with the associated costs and savings of each measure. Find information on the different funding options, trusted suppliers and procurement routes so that you can plan your next steps.
Coronavirus (COVID-19) Survey. It is important that social care providers complete this survey to support & maintain the supply of free PPE.
Extending free PPE to the health and care sector
DHSC is seeking views on whether it should extend the provision of free personal protective equipment (PPE) to the health and care sector after 31 March 2022.
Permanent Process for VCOD exemptions
DHSC has just published the full process for medical exemptions for vaccinations and testing. The policy applies from yesterday and so the temporary self-exemptions will expire on 23 December. A summary:
- If you believe you are medically exempt from vaccination, phone the NHS COVID Pass service on 119 and ask for an NHS COVID Pass medical exemptions form. The call handler will ask some questions and you will have to provide your name, date of birth, NHS number (if known) and GP/specialist clinician.
- If you’re eligible you will be sent an application form by post.
- Return your application form to the GP or relevant clinician stated on the form. Your application will be clinically reviewed by your doctor, specialist or midwife. Your GP, specialist or midwife may ask to speak with you if needed.
- You’ll automatically get the results of your application by post 2 to 3 weeks after applying. You don’t need to contact the GP.
- If you get a medical exemption you can use the domestic NHS COVID Pass wherever you need to. You can access this via the NHS app or NHS website. This can be downloaded as a PDF. The pass won’t show others that you have a medical exemption – it will simply show a pass. A paper version of the pass will be available soon.
- The clinical decision on your medical exemption is final. It cannot be appealed.
A carer can also do the above process on someone’s behalf. The guidance also gives some examples of why someone might be medically exempt but it doesn’t appear to be an exhaustive list:
- people receiving end of life care where vaccination is not in the person’s best interests
- people with learning disabilities or autistic individuals, or people with a combination of impairments where vaccination cannot be provided through reasonable adjustments
- a person with severe allergies to all currently available vaccines
- those who have had an adverse reaction to the first dose (such as myocarditis)
- Short term exemptions for those with short term medical conditions. Pregnant women can take this route but their exemption will expire 16-weeks post-partum to allow them to be vaccinated.
‘Pregnant women can alternatively use MAT B1 certificates to show their COVID status, if they choose to use a medical exemption. Pregnant women do not need to apply for a medical exemption NHS COVID Pass if they have a MAT B1 certificate. For pregnant women who use the MAT B1 form to show their exemption, the exemption will expire 16 weeks post-partum. This will allow them to become fully vaccinated after birth.’
Acas Learning Online is a package of free e-learning modules.
They cover a range of employment, management and HR issues, including:
Covid-19 vaccinations in the workplace (new)
This new e-learning course offers good practice advice on how employers can best support staff to get Covid-19 vaccinations and explains the recent law introduced by the Government around vaccinations in certain settings. We cover how to agree a vaccine policy that’s appropriate for your workplace, staff who may be exempt and how to strike that balance between protecting the health of staff whilst maintaining good working relationships to help avoid disputes in the future.
Try Covid-19 vaccinations in the workplace e-learning today
Other e-learning topics include: Flexible working – mental health in the workplace – change management – contracts of employment – recruitment and induction – discipline and grievance – handling redundancies – managing absence
Access free Acas e-learning here We encourage you to share this free resource widely with your team and with colleagues throughout your organisation.
The Bournemouth Uni MCA toolkit FREE & USEFUL
has been shared with us via the email below and you can access it by the link. Please share with colleagues as this is a useful tool for all staff to use in relation to the MCA – it is free and the plan is this will become an app.
Bournemouth University have launched ‘Mental Capacity Toolkit’, a learning tool to support nurses and other practitioners in their understanding and duties under the HRA and MCA.
Living Wage in Social Care: Toolkit Launch
The toolkit is now live on our website – you can read it and download a copy using this link. Please do share this with any colleagues or connections you think may be interested.
You can also view and download Dr Andrea Werner’s report (including in-depth interviews with accredited Living Wage Employers), Living Wage Implementation in Adult Social Care: challenges, solutions and benefits using this link.
We’re excited to continue our work aiming to grow the Living Wage in social care. If you have any questions about this work, please don’t hesitate to get in touch.
PERSONALISATION IN BLACK, ASIAN AND MINORITY ETHNIC COMMUNITIES
TLAP commissioned this project to find examples of promising practice that demonstrate what good personalised community-based care and support looks like for people in ethnically diverse communities. Fourteen organisations across England feature in this report, offering a wide range of support and services in particular groups and communities.
Double Handed Dom Care
My name is Dr Leigh Rooney Leigh.Rooney@newcastle.ac.uk and I am part of a team based at Newcastle University researching the experiences of those involved in care at home that requires two carers (double-handed homecare). As part of this we would like to interview homecare workers who have experience of both double-handed and single-handed homecare. The project aims to use its research data to produce best practice recommendations for how reviews of double-handed homecare packages are conducted within local authorities, and we recognise that the experience of homecare workers is crucial to this. Participation would involve a single telephone/video interview of around 45 minutes, with the resulting data being anonymised (identification of participants should not be possible). As a thank-you each homecare worker participant will be offered a £25 voucher.
We wonder whether you would be able to help us pass information about our study to homecare providers who might be interested in our study? We have produced a one-page leaflet that you could distribute should you be willing (see attached).
Our study is funded by the National Institute for Health Research (NIHR) – Research for Social Care (reference NIHR200040), and has received ethical approval from the Health Research Authority (reference 19/WM/0224).
I very much look forward to hearing back from you.
Dr Leigh Rooney Leigh.Rooney@newcastle.ac.uk
Population Health Sciences Institute
Faculty of Medical Sciences
Flu vaccination guidance for social care workers can be found here. Material to promote the flu vaccine can be found within a new winter vaccination campaign for both vaccines: https://campaignresources.phe.gov.uk/resources/campaigns/92-health-and-social-care-workers-winter-vaccinations-2021
|Temporary medical exemptions For COVID-19 vaccination Of people working / deployed in care homes|
|Dear Colleague, Regulations were approved by Parliament on 22 July 2021 to make vaccination a condition of deployment for staff working in CQC-regulated care homes in England, unless they have a medical exemption. A 16-week grace period was put in place to ensure staff who haven’t been vaccinated could take up the vaccine before the regulations come into force on 11 November 2021. Thanks to the incredible efforts of people across the care sector to encourage and reassure colleagues about vaccination, as of 9 September, 90.4% of care home workers have now had a first dose of a COVID-19 vaccine, with 82.2% of care home staff now fully vaccinated. The Department of Health and Social Care has been working as quickly as possible to ensure that people who are not able to get the vaccine for medical reasons are not disadvantaged. On a temporary basis, from today, people working or volunteering in care homes who have a medical reason why they are unable to have a COVID-19 vaccine will be able to self-certify that they meet the medical exemption criteria, using the forms attached to this letter. Care home workers who are exempt will need to sign the form attached to this letter and give this to their employer as proof of their temporary exemption status. This temporary self-certification process has been introduced for a short period prior to the launch of the new NHS COVID Pass system which will go live imminently. Once the NHS COVID Pass system is launched, care home workers will need to apply for a formal medical exemption through that process. This temporary self-certification will expire 12 weeks after the NHS COVID Pass system is launched. Who is exempt: While this list is not exhaustive, examples of medical exemptions from COVID-19 vaccination could include individuals: Receiving end of life care where vaccination is not in the individual’s interests. With learning disabilities or autistic individuals, or with a combination of impairments which result in the same distress, who find vaccination and testing distressing because of their condition and cannot be achieved through reasonable adjustments such as provision of an accessible environment. With medical contraindications to the vaccines such as severe allergy to all COVID-19 vaccines or their constituents. Who have had adverse reactions to the first dose (e.g. myocarditis). Time-limited exemptions will also be available for those with short-term medical conditions (e.g. people receiving hospital care or receiving medication which may interact with the vaccination). A time-limited exemption is also available for pregnant women should they choose to take it. Exemptions for conditions listed in section 4.4 (special warnings and precautions for use) in the Summary of Product Characteristics for each of the approved COVID-19 vaccines (Pfizer, AstraZeneca and Moderna) may also be considered. Individuals that have received a COVID-19 vaccination abroad can also self-certify as medically exempt. This is because it is not clinically appropriate for them to be vaccinated in the UK if they have already received a partial or full course of vaccination overseas. We will update the operational guidance we have already published in the coming days to reflect the temporary exemption system outlined in this letter.|
Presentations and recording of the RM V-Meeting September 8th 2021.
Thanks to our speakers from CQC & SfC and apologies to those who were not able to join due to a Zoom issue.
CQC – Emma MacFarlane –
SfC – Selena Docherty & Laura Anthony –
Event recording – https://youtu.be/Gb2i2l3dQfg
Capacity Tracker Survey – Please Respond
NECS would like to help providers make the most of the Capacity Tracker, including finding information to support your organisation. Please could you take a minute to complete this short 4 question survey so that they can better tailor their support and help you to complete the Capacity Tracker quickly and easily. It is your chance to influence how you are supported to complete the tracker. The closing date for the survey is Friday 17th September 2021.
To complete the survey, go to https://www.surveymonkey.co.uk/r/C5QLH82.
Five top Health & Safety mistakes & how to prevent them
The Health & Safety Executive (HSE) has published that a total of 142 workers were fatally injured in the workplace in 2020/21 – an increase of 29% from the previous year.
The Health & Safety experts of LCAS partner, Citation, work with thousands of clients up and down the country, helping business owners get Health & Safety right in their business.
Whether you need a quick refresher, or your usual Health & Safety obligations have taken a backseat during COVID, they’ve put together this exclusive free guide to give you an insight into the most common Health & Safety mistakes they see, and their top tips on how to avoid them in your business.
Your LCAS member benefit
If you’d like to chat about how Citation can help with the HR and Health & Safety side of your business, just give us a call on 0345 844 1111, or fill in our call-back form and they’ll get right back to you.
Quote ‘London Care & Support Forum’ when enquiring to access your member benefit.
JCVI advice on third dose vaccination for severely immunosuppressed
The JCVI is advising that people with severely weakened immune systems should have a third vaccine dose as part of their primary COVID-19 vaccination schedule. This is separate to any potential booster programme (see below).
The JCVI’s offer is to people over the age of 12 who were severely immunosuppressed at the time of their first or second dose, including those with leukaemia, advanced HIV and recent organ transplants. The idea is to provide an extra dose for those who may not have generated a full immune response to the first 2 doses. The third dose should usually be at least 8 weeks after the second dose but there is flexibility if this is not possible. mRNA (Moderna and Pfizer) vaccines will be used for the third doses. Those who receive a third dose should also receive a later booster vaccine.
You can find more detail, including full information about who this applies to, in the following links:
CPA Webinars on making vaccination a condition of deployment & visiting
The presentations and Q&A from the webinar on 23 August have now been published here.
There will be a further two webinars, one on workforce and HR issues as a result of the new vaccine policy and the other looking at how to overcome barriers to rolling out the Essential Care Giver role and wider visiting arrangements in care homes. Sign up using the links below:
- Vaccination as a condition of deployment: workforce and HR issues – 16 September, 4-5pm
- Visiting care homes, plus Essential Care Giver – 17 September, 9:30-11am
CQC Strategy Surveys
CQC is looking for feedback on a number of different surveys:
- Coproducing changes to assessment frameworks: draft quality statements for ‘safe’ and ‘effective’
- Coproducing changes to assessment frameworks: draft quality statement for ‘well-led’, ‘responsive’ and ‘caring’
- People’s experiences of care
- Outputs and reporting
- Evidence and rating a service
- Quarterly pulse survey
Please find attached details of the plans for vaccination Phase 3.
The process for vaccinating care home staff and the schematic slide, is dependent on some tech and data solutions.
All plans are subject to confirmation by JCVI.
Agency Staff Costs… Are You Paying Too Much VAT?
VAT Solutions have been able to reduce such agency costs for some of our clients, as we have found that many care operators are not aware that through an HMRC extra-statutory concession, supplies of nurses, nursing auxiliaries and care assistants by state-regulated agencies (the nursing agencies’ concession) to a third party could be treated as VAT exempt. Nursing agencies (or employment businesses that provide nurses and midwives, as well as other health professionals) may exempt the supply of nursing staff and nursing auxiliaries supplied to a third party, if the supply is of:
- A registered qualified nurse or midwife (under article 5 of the Nursing and Midwifery Order 2001) providing medical care to a final patient.
- An unregistered nursing auxiliary who is ‘directly supervised’ by one of the above.
Is your care provision employing agency staff in either of the above capacities? If you are being charged VAT on such supplies and think that the HMRC concession could be applicable, we would be happy to talk you through in more detail…. Read the full article here.
To speak to a care sector VAT specialist regarding the above, please contact Emma Harrison at VAT Solutions email@example.com Tel: 0114 280 363
Changes to self-isolation guidance for care settings
Following the 16-August changes to self-isolation guidance, the guidance for social care settings has been updated.
Due to the success of the vaccination programme, we are now able to remove the self-isolation requirement for fully vaccinated people who are:
- A contact of someone who has tested positive for COVID-19;
- Returning to their care home following a planned hospital stay; or,
- Transferring from another care facility.
In adult social care settings, the self-isolation exemption for fully vaccinated contacts means:
- Staff who are a contact can continue working if they have no symptoms and have a negative PCR test, followed by daily LFD tests for 10 days (from the point of contact). If the staff member works with patients or residents who are clinically extremely vulnerable to COVID-19 (as determined by the organisation), a risk assessment should be undertaken, and consideration given to redeployment during the 10-day period;
- Residents in care homes who are a contact should not be required to self-isolate if they have no symptoms and have a negative PCR test. This should be followed by daily LFDs for 10 days (from the point of contact). Residents can continue to receive visitors unless there is an outbreak in the care home; and,
- Visitors to care homes who have been identified as a contact are advised against visiting for 10 days after contact unless absolutely necessary. Where visits do occur, visitors should have received a negative PCR result, and a negative LFD result on the day of their visit.
The below pieces of guidance have been updated:
COVID-19: guidance for supported living – GOV.UK (www.gov.uk) Please find attached a letter from our Director, Claire Armstrong, detailing the changes and guidance, as well as a Q&A.
Guidance for Domiciliary Care
The ‘How to Work Safely in Domiciliary Care’ guidance has been updated and now includes a paragraph on what PPE to use when supporting an individual or client on visits out. Some key things to note:
- The risk assessment section has been updated to include what to do in a situation where a client is displaying early symptoms of COVID-19
- If an outing with a client will include direct personal care, the correct PPE should be used as outlined in the section within 2 metres and carrying out direct personal care or domestic duties
- Occasional physical support or assistance with everyday tasks does not require gloves or aprons
- Face coverings should be worn on public transport and in crowded enclosed spaces where clients will be in contact with people they do not normally meet
- Type I or II surgical masks are sufficient unless the employer has a good supply of Type IIR masks
The guidance has also been updated to include contact details for the Health and Safety Executive if staff have concerns about their safety.
Free Citation employment law guide on compulsory vaccination in care home settings
Both Skills for Care and the operational guidance for vaccination as a condition of deployment cite Acas as the organisation to provide impartial advice to employers, employees, and their representatives on:
- employment righs
- best practice ad policies
- resolving workplace conflict
We have been told that the helpline service has been fully briefed to respond to calls and inquiries in relation to vaccination as a condition of deployment. If you have used this helpline for this purpose, NCF would be very interested in hearing your experiences. There are a number of unknowns about how useful this service will be in the limited time to implement the policy.
Acas also has a series of advice pages dedicated to the new policy or issues related to it – see page 41 of the operational guidance for a list of page links.
Strategic framework call for evidence 2021
Health Education England (HEE) has been commissioned to work with partners to review long term strategic trends for the health and social care workforce.
This will review, renew and update the existing 15-year strategic framework for workforce planning, Framework 15. While Framework 15 focused on health only, this update will extend into social care, encompassing regulated professionals in social care for the first time.
For full information and details of events –
CQC statement on how they will monitor vaccination regulationsOngoing monitoring and inspection
- Monitoring that providers comply with the Regulations is CQC’s responsibility.
- We propose to add the following question to the Provider Information Return (PIR) once this duty is in place: ‘How are you assured that those you employ and deploy within your service have had their mandatory vaccinations?’
- We will also build a similar question into our monitoring approach once this duty is in place. Further information will be provided in due course.
- Where we have information of concern, through any route, we will follow this up. This may include seeking assurance from the provider or carrying out an on-site inspection.
- On inspection, where the information we hold identifies concerns, we will look for evidence to confirm systems and processes are in place to comply with the requirement.
- Registered persons will not be required to show a record of the evidence itself to inspectors but will need to be able to provide reassurance that systems and processes are in place to ensure individuals who enter the premises are fully vaccinated. Registered persons may choose to make a record of the evidence they have seen for their own internal staff employment record keeping. If the evidence is collected and recorded, all personal data must be handled in accordance with UK GDPR. This includes providing individuals with privacy information at the stage their data is being collected. Please refer to the guidance from the Information Commissioner’s Office to ensure you have the appropriate lawful basis, technical and security measures in place to protect personal data.
- Registered persons (or those acting on behalf of the registered person) must check that anyone wishing to enter the premises has received a full course of vaccination, unless they are exempt. CQC inspectors are included within the scope of visiting professionals for the purpose of this Regulation and we are considering the practical implications of this for our staff in exercising their regulatory activity. Compliance with the Regulations would be an appropriate reason for not granting access to a CQC inspector, or another individual, unless they are exempt.
Free Neil Eastwood Recruitment Masterclasses – Are you finding it harder and harder to recruit care staff?
Take my online Masterclass to protect your care organisation from the worsening recruitment catastrophe… it is now FREE to access!
You can see it at www.findandkeepthebest.com