Funding for new Infection Control Measures in Care Homes and how they might spend it.

2020 has been for many a tough year, and as we enter Autumn, and approach Winter, many will fear and dread the threat of COVID and Flu. Much has been made of the deaths in social care from the first wave of the pandemic. It is fair to say mistakes were made, and there were lessons to be learned. Throughout winter, it will be essential that local authorities and NHS organisations continue to collaborate, working alongside one another, as well as with adult social care providers (including in the voluntary and community sector), people with care and support needs, their families and carers, and national government, if we are to keep the virus at bay.

Professor Adam Gordon told Channel 4 News that discharging patients from hospital to care homes was “accelerated and escalated” in the early months of the pandemic and that it could happen again in line with the latest UK Government guidance.

UK government guidance updated on September 16 reiterates that care homes in England should be prepared to accept COVID-19 positive patients from hospitals.

“As part of the national effort, the care sector also plays a vital role in accepting patients as they are discharged from hospital, because recuperation is better in non-acute settings.

Earlier in the pandemic, tests were not required before discharging patients from hospitals to care homes.

The latest data from the Office for National Statistics is that there have been 15,501 COVID-19 related deaths in care homes in England and Wales up to 4 September.

Professor Adam Gordon, of the British Geriatrics Society, has been running a “red zone” COVID ward in a hospital during the pandemic and says infection control precautions taken in hospital present a challenge for care homes to replicate. “It can be very difficult to isolate people with COVID safely. And it’s a really quite significant burden to place on care homes to take that responsibility when they perhaps haven’t been able to see the patient and aren’t quite sure what their care needs will be at the point of discharge. Care homes are not hospitals. They are designed to be homes, and, in many instances, care home staff are not healthcare professionals who in the past have had really in-depth training in infection control. The last time around we saw the hospital system under pressure and part of the response of that was to try to accelerate and escalate discharge into care homes. If we see similar pressures on the hospital sector this time around then it will be commonplace under the current guidance that people who are COVID positive will be discharged back into care homes.”

A spokesperson for Trafford Council said: “The discharge of patients from hospital is a carefully co-ordinated process in line with national government guidance. At all times, the health and wellbeing of the person being discharged is our primary concern and, if they are discharged to a care home, we make sure it is one that meets their health and social care needs. The alternative to doing this would be to leave the person in hospital. This would mean that the person’s recovery may take longer in an inappropriate setting, leaving them at higher risk of infection while also preventing seriously ill people being admitted to hospital to receive critical care when they need it.”

For local authorities, this relates to both self-funded care providers and local authority commissioned services within the authority, including those with whom the local authority does not have a contract.

One key action is improving infection control. The Government has announced the National Adult Social Care Infection Control Fund. The Minister for Care, Helen Whately MP, wrote to councils to announce an additional £600m of Government funding to support providers through a new ‘Infection Control Fund’.  The letter states that the fund will support adult care home providers to reduce the rate of transmission of coronavirus (COVID-19) in and between care homes and support wider workforce resilience. In this article we look at the guidance Essex County Council has sent to care homes across the county.

Essex will receive £16.3m for our Infection Control Fund, this guidance outlines the process and provides information on how the fund will be distributed to care homes in Essex.

To be eligible for support from the grant, providers who do not already must complete the daily care home NHS Capacity Tracker.  The fund has been calculated based on the number of beds identified on the NHS Capacity Tracker as of 3rd June.

A small percentage of it may be used to support domiciliary care providers and support wider workforce resilience to deal with COVID-19 infections.

Grant Usage Ideas

Essex County Council have produced some ideas for products and solutions which would improve IPC with regards to the direct threat of COVID-19.

This document provides a range of ideas (updated 05 Aug 2020) ECC has received from providers in relation to the Infection Control Fund for Care Homes, with a view from ECC as to whether it is an acceptable use of the fund or not.  Please note this document will be updated as and when additional ideas / information is received to support providers with the use of the infection control fund. Ideas include using the fund for additional IPC training, communication devices(laptops/tablets) to minimise contact, decontamination machines, and refurbishments to make surfaces cleanable. Items such as PPE and chemicals are not included as they are financed and provided by other sources already.

Other national government measures include,

work relentlessly to ensure sufficient appropriate COVID-19 testing capacity and continue to deliver and review the social care testing strategy,

  • work to improve the flow of testing data to everyone who needs it
  • provide free personal protective equipment (PPE) for COVID-19 needs in line with current guidance to care homes and domiciliary care providers, via the PPE portal, until the end of March 2021
  • make available for free and promote the annual flu vaccine to all health and care staff, personal assistants, and unpaid carers
  • COVID Hospital Discharge-The new requirements are the following: Anyone with a Covid-19 positive test result being discharged into or back into a registered care home setting1 must be discharged into appropriate designated setting (i.e., that has the policies, procedures, equipment and training in place to maintain infection control and support the care needs of residents) and cared for there for the remainder of the required isolation period.  These designated accommodations will need to be inspected by CQC to meet the latest CQC infection prevention control standards.  No one will be discharged into or back into a registered care home setting with a COVID-19 test result outstanding, or without having been tested within the 48 hours preceding their discharge.  Everyone being discharged into a care home must have a reported COVID test result and this must be communicated to the care home prior to the person being discharged from hospital. The care home’s registered manager should continue to assure themselves that all its admissions or readmissions are consistent with this requirement. Sufficient accommodation must be available to meet expected needs now and over the winter period. The costs of the designated facilities are expected to be met through the £588 million discharge funding. This guidance still requires all patients discharged from hospital, even with a negative test, to be isolated safely for 14 days to ensure any developing infections are managed appropriately. The CQC process would operate by providing assurance that each ‘designated accommodation’ has the policies, procedures, equipment, and training in place to maintain infection control and support the care needs of residents.

By putting in place stronger prevention, we can ensure that we continue to drive coronavirus out of our care homes, making them safer and better able to look after people who need it the most.” Rachel Maclean MP Redditch.

Cllr David Fothergill, health and social care spokesperson for the County Councils Network, said: “The announcement that infection control funding is going to be renewed for over the winter is reassuring to our staff and care providers who are facing up to a difficult few months. We need to learn from the lessons of the first wave of coronavirus and ensure that government provides social care with the necessary protection it needs over the winter period, instead of seeing the sector as an afterthought to the NHS.

 “County authorities have worked quickly to distribute this previous pot of funding directly to providers and will continue to do so over the coming weeks as we prepare for additional pressures during winter.

“We will encourage ministers to make sure the criteria for distributing the fund is as simplified as possible, so councils can get it to the frontline as quickly as possible.”