Coronavirus: Infection Prevention and Control
Good infection prevention and control is central to reducing and delaying the spread of coronavirus. Key infection control resources are highlighted here.
The Government is introducing legislation that will require care home providers to restrict all be essential movement of staff between settings in order to reduce transmission of COVID-19 – with a particular focus on care home staff. At the same time, care homes are facing staff shortages due to sickness and the ongoing high vacancy rates.
This Care Provider Alliance briefing outlines a risk management approach care homes can use to manage restrictions on staff movements. The briefing relates to CQC registered care homes with or without nursing in England.
The Care Provider Alliance (CPA) welcomes the Care Quality Commission’s latest report on infection prevention and control during the coronavirus pandemic. Speaking about the report, Kathy Roberts, CPA chair said: “CQC’s very timely report provides further evidence and examples to support continuous improvement in this area and we look forward to working with CQC on this crucial issue for care providers, their staff and the people they support.”
In response to the challenges of the COVID-19 pandemic CQC have introduced Infection Prevention and Control inspections in order to share good practice, uphold high quality care and keep people in care safe.
As this report shows most care providers that CQC have inspected have shown they are responding to the challenges of infection prevention control well, under these extraordinary circumstances.
The risk of contagion is highest indoors but can be reduced by applying all available measures to combat infection via aerosols. This series of graphics provides an overview of the likelihood of infection in different scenarios.
Paper prepared by EMG and NERVTAG on SARS-COV-2 transmission routes and environments. It was considered at SAGE 63 on 22 October 2020. The paper is the assessment of the evidence at the time of writing. As new evidence or data emerges, SAGE updates its advice accordingly.
“Evidence continues to indicate the SARS-CoV-2 can be transmitted by three main routes: close-range respiratory droplets and aerosols, longer range respiratory aerosols, and direct contact with surfaces contaminated with virus. Close-range transmission is likely to be the most significant, but there is not yet sufficient evidence to confidently separate out the relative importance of these routes or how they vary between settings (medium confidence).”
“The COVID19 pandemic is strongly shaped by structural inequalities that drive household and occupational risks, such as prolonged working hours in close proximity to others and/or in high risk occupations, use of public transport, and household crowding. It is essential to tailor effective control and recovery measures to the greater needs and vulnerabilities of disadvantaged communities (high confidence).”
The VIVALDI-1 survey was set up before Capacity Tracker was widely used. It collected information on the number of staff and residents in each care home and the number of confirmed COVID-19 infections. The study found that infections and outbreaks were less likely in care homes that:
- Paid statutory or more than statutory sickness pay to staff (compared to homes that did not provide sickness pay at all)
- Made sure staff only worked with either infected or uninfected residents, not both
- Did not employ bank or agency nurses or carers
- Had higher numbers of staff per resident.
The Local Government Association has issued further notes to local authorities regarding the use of the ICF 2. You can download the links below:
The Better Care Fund team will be hosting a webinar on infection prevention and control in care homes next Tuesday, 20 October at 2pm. A cancellation message was sent in error to those already registered. The webinar is going ahead. Contact email@example.com.
This updated Care Provider Alliance (CPA) briefing note provides further information and examples to support care providers’ reports to local authorities on additional expenditure on infection control arrangements because of COVID-19. It can be used by care providers to consider potential additional costs. Arrangements will vary across local authorities. If a care provider is unsure if a potential expenditure would be in scope of the Infection Control Fund Round 2, they should discuss this with their local authority.
CQC’s inspection teams have been using an information gathering tool to look at how well staff and people living in care homes are protected by infection and control. They have recently completed some work making small changes to the questions so that they collect better information. Changes are highlighted in red on this PDF.
Letter from Helen Whatley, Minister of State for care MP regarding the second ICF fund worth £546m available for infection control expenditure until March 2021.
Infection Control Fund: round 2 - 1 October 2020 – GOV.UK
Government guidance sets out the infection control measures that the new infection control fund will support, including information on the distribution of funds and reporting requirements.
Local authorities should pass 80% of each instalment directly to:
- care homes within the local authority’s geographical area on a per beds basis
- CQC-regulated community care providers (domiciliary care, extra care and supported living) within the local authority’s geographical area on a per user basis.
Government expects this to take no longer than 20 working days upon receipt of the funding in a local authority, subject to providers meeting the conditions as stated in the local authority circular (October 2020).
The other 20% of the funding must be used to support care providers to take additional steps to tackle the risk of COVID-19 infections but can be allocated at the local authority’s discretion. (Note this can include “paying care staff their usual wages in order to attend a GP or pharmacy to be vaccinated against flu outside of their normal working hours”.
The funding will be paid in 2 tranches. The first will be paid to local authorities on 1 October 2020. The second tranche will be paid in December 2020.
Government expects the grant will be fully spent on infection control measures (as outlined in the grant determination letter) by 31 March 2021. ‘Spent’ means that expenditure has been incurred on or before 31 March.
Sets out the infection control measures that the infection control fund will support, including information on the distribution of funds and reporting requirements. Added updated document ‘Reporting template: annex E of circular’ and updated deadline to 30 September 2020.
The Care Provider Alliance (CPA) welcomes the government’s promise of extra funding as part of the Infection Control Fund and the announcement of the new Adult Social Care Winter Plan.
A new adult social care winter plan to support care homes through winter including free PPE and £546 million Infection Control Fund
- Care providers must stop all but essential movement of staff between care homes to prevent the spread of infection
- People receiving adult social care and care workers will receive free PPE
- A new dashboard will monitor care home infections and help local government and providers respond quicker
- A Chief Nurse for Adult Social Care will be appointed to represent social care nurses and provide clinical leadership to the workforce
Government is prepared to strengthen monitoring and regulation by local authorities and the Care Quality Commission (CQC), including asking them to take strong action where improvement is required or staff movement is not being restricted
Further details of how the winter plan will be enforced will be set out shortly.
The unveiling of the winter plan will be supported by the publishing of the Adult Social Care COVID-19 Support Taskforce report highlighting the effectiveness of the fund and the care home support package.
The Infection Control Fund has been extended to ensure care homes have the resources they need to halt transmission of COVID-19 throughout winter.
The fund can be used to pay staff wages for those self-isolating and hire more staff to restrict movement between homes.
Stuart Miller has written to care providers to highlight rising infection rates and request action on testing and PPE in all care settings. Key points from the letter incluide:
- portal is now open for care homes for working age adults to register for repeat testing. Care homes that have not yet registered for repeat testing are encouraged to do so
- each care home needs to reorder kits towards the end of each round of testing. Care homes are able to reapply 21 days after their last order
- ensure staff are following the PHE guidance relating to PPE:
- for all care settings: Personal Protective Equipment (PPE) illustrated guide for community and social care settings
- for care homes: COVID-19: how to work safely in care homes
- for domiciliary care: COVID-19: how to work safely in domiciliary care in England
- care home and home care providers can use the PPE Portal to order and receive critical coronavirus (COVID-19) personal protective equipment (PPE).
- the Adult Social Care Winter Plan will set out the support and resources we will make available nationally, as well as describing the actions for local areas
Guidance on the use of personal protective equipment (PPE) for aerosol generating procedures (AGPs). Updated headings on instruction sheets, in line with the written guidance, to include airborne precautions.
The National Care Forum (NCF), Quality Compliance Systems (QCS) and Standards Wise International have developed an audit tool that supports organisations to assess their own practices, and prepare evidence for audit which meets CQC requirements and also conforms to international standards.
The tool is structured around eight questions and prompts that CQC inspectors will use to assess infection prevention and control procedures in all care settings in England from September.
The Minister for Care has written to Directors of Adult Social Care yesterday about the infection control fund. The letter clarifies intentions around the clawback mechanisms to try and reassure providers who have concerns around accepting this funding.
The letter states:
“Where providers have used funding on infection control measures as set out in the Grant Circular or as discussed with the Department, then the Department’s unequivocal position is that this will not be clawed back. I also expect the local authority to provide assurance to each provider to the same effect. I should be clear that the principal policy intent of the clawback provision is to ensure that local authorities distribute all the £600m funding to providers as quickly as possible, and that the department will reclaim any funding that is not distributed by local authorities to providers. While it is also correct that the clawback provisions enable us to recover any grant that is not used for the purposes it was given, to comply with state aid rules, as I have set out we do not envisage using it for such purposes unless there is a fraudulent activity or clear misuse of these public funds.”
This guidance describes the principles of cleaning and disinfection during the coronavirus (COVID-19) pandemic. It applies to non-healthcare settings outside the home, such as hotels, non-care work places, etc. It is not aimed at care settings, but may be of interest to care providers in relation to office spaces.
Explanation of what face coverings are, their role in reducing the transmission of coronavirus (COVID-19), the settings in which they are recommended, and how they should be safely used and stored. This information is based on current scientific evidence and is subject to change. This information relates to the use of face coverings in public spaces where social distancing is not always possible.
Government information on coronavirus includes a section on Local Lockdowns. This currently covers information on social distancing, education and childcare settings, travel, and specific information regarding Leicester.
How public health officers apply Schedule 21 to the Coronavirus Act 2020 in response to the COVID-19 pandemic.
This document sets out the waste management approach for all healthcare facilities including primary care facilities and testing facilities in England and Wales during the COVID-19 outbreak.
The ADPH has developed an ‘explainer’ about Local Outbreak Plans to support stakeholders, the media and the public in understanding what they are and how they will work.
This CPA briefing note provides further information and examples to support care providers’ reports to local authorities. It should be read alongside the Government guidance and related annexes.
The CPA is suggesting a limited number of different areas at a top level against which care providers can easily allocate costs, whilst also giving a series of examples to prompt providers to think about how to consider their full range of costs.
Full guidance on the Adult Social Care Infection Control Fund, and annexes including reporting templates.
The Adult Social Care Infection Control Fund is worth £600 million. The primary purpose of this fund is to support adult social care providers, including those with whom the local authority does not have a contract, to reduce the rate of COVID-19 transmission in and between care homes and support wider workforce resilience. A small percentage of it may be used to support domiciliary care providers and support wider workforce resilience to deal with COVID-19 infections.
This Q&A has been prepared by the Department of Health and Social Care in response to a number of questions received from local government and care providers. Nothing contained within it supersedes the terms of the grant determination document.
The primary purpose of the £600m fund is to support adult social care providers, including those with whom the local authority does not have a contract, to reduce the rate of COVID-19 transmission in and between care homes and support wider workforce resilience. A small percentage of it may be used to support domiciliary care providers and support wider workforce resilience to deal with COVID-19 infections. This funding will be paid as a Section 31 grant ring fenced exclusively for actions which support care homes and domiciliary care providers mainly to tackle the risk of Covid19 infections and is in addition to funding already received. See also the Minister’s letter of 22 May 2020.
A new care homes support package including a £600 million adult social care infection control fund has been introduced to tackle the spread of COVID-19 in care homes. Read the Ministerial letter, information on the package, and template for local authorities.
Guidance for those working in care homes providing information on how to work safely during this period of sustained transmission of COVID-19. Includes guidance on use of PPE.
Range of Public Health England guidance and resources for health and care staff on infection prevention and control during coronavirus outbreak. Resources include:
Guidance on admissions for care homes includes annex E on infection prevention. Care homes are not expected to have dedicated isolation facilities for people living in the home but should implement isolation precautions when someone in the home displays symptoms of COVID-19 in the same way that they would operate if an individual had influenza or diarrhoea and vomiting.
CPA guidance on infection prevention and control to protect the health and well-being of service users in care settings, and to reduce the effect of an infection outbreak on service provision. Effective infection prevention and control depends on early recognition and timely intervention. This in turn depends on surveillance of infection. This document should be used in conjunction with national guidance and local policies.
CPA has also published a helpful checklist that you could use to help you prevent and control the spread of infection in your care setting. This document should be used in conjunction with national guidance and local policies. It should also be used to complement the guidance on Infection prevention and control.
Download or order free resources, such as leaflets, posters, guides and resource packs
Regularly and thoroughly washing hands reduces the spread of infection. Wash hands for at least 20 seconds. Avoid touching your face.
Government announces that all care homes and home care providers will be automatically sent fluid repellent facemasks
Download a PDF of notes from webinar with Deputy Chief Medical Officer, and access the audio recording.
Those handling bodies should be aware that there is likely to be a continuing risk of infection
See all related information on coronavirus.