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Hundreds of dedicated Covid-positive care homes are to be set up in an effort to keep patients discharged from hospitals from spreading the virus more widely, as happened in the first wave of the pandemic.
The Department of Health and Social Care (DHSC) has instructed councils to identify homes in their areas that could be used and to have them checked by inspectors to assure infection prevention controls are in place. As many as 500 facilities – sometimes known as “hot homes” – could be designated by the end of November, the equivalent of one or two in each council area.
The move was first flagged in September in the government’s winter plan for adult social care when it said it was developing a designation scheme with the Care Quality Commission (CQC) “for premises that are safe for people leaving hospital who have tested positive for Covid-19 or are awaiting a test result”.
The letter to local authority directors of adult social care, seen by the Guardian, says the Covid homes should be “stand-alone units or settings with separate zoned accommodation and staffing”.
It adds that “given the diversity of existing provision and arrangements, it is acknowledged that there needs to be flexibility to meet local circumstances”.
Before anyone is discharged into one of the homes from hospital with a positive Covid test result, the unit must be registered with the CQC and the regulator will check it has the “policies, procedures, equipment and training in place to maintain infection control and support the care needs of residents”, the DHSC said.
In a clear sign the policy is aimed at freeing up hospital space as well as reducing cross-infection, the homes will not be used for people who contract Covid in their existing care home or at home. Councils have been asked to supply locations by the end of this week and the Department of Health wants every local authority to have access to at least one CQC-designated accommodation by the end of October.
Some care bosses have reacted with concern to the proposal, with some suggesting patients being discharged, albeit with a Covid diagnosis, will be reluctant to enter a hot home and that staff, many earning the minimum wage, will be asked to risk their health by working in one.
The DHSC said councils needed to “ensure that there is repeat testing, PPE, arrangements for staff isolation or non-movement, protection from viral overload, sickness pay and clinical treatment and oversight”.
While a few care homes that opened recently may be only partially occupied and so could be transformed into Covid step-down facilities, the instruction will require others to try to separate staff and residents. Earlier in the pandemic some councils struggled to get insurance to reopen closed care homes to be used for Covid-positive residents.
What the UK government said on Covid testing
“Not only are we getting the pandemic under control, with deaths down and hospital admissions way, way down, but we will continue to tackle it, with local lockdowns and with our superlative test-and-trace system.”
“NHS Test and Trace is doing a heroic job, and today most people get an in-person test result within 24 hours, and the median journey is under 10 miles if someone has to take a journey to get one … [To Keir Starmer] We make the tough calls – all he does is sit on the sidelines and carp.”
[On the ‘moonshot’ proposal for mass, near-instant testing:] “We are hopeful this approach will be widespread by the spring and, if everything comes together, it may be possible even for challenging sectors like theatres to have life much closer to normal before Christmas.”
“We don’t have enough testing capacity now because, in an ideal world, I would like to test absolutely everybody that wants a test immediately … Yes, there’s a long way to go, and we will work night and day to ensure that we get there.”
“Of course there is a challenge in testing … We have sent tests to all schools to make sure that they have tests available. But of course I also recognise the challenges in getting hold of tests … Tests are available, even though it is a challenge to get hold of them.”
Sam Monaghan, the chief executive of MHA, the largest charitable provider of care homes in the UK, said he was “highly concerned” about bringing infected people “into close communities where the risk of spread is considerable and you are asking staff to place themselves in the way of potentially contracting the virus as well”.
“Unless you are talking about care home providers who have buildings that aren’t yet occupied, it will mean moving people out of their home, their room,” he told Radio 4’s Today programme. “You would be separating your staff into those working without Covid and those working with Covid and what the arrangements and protections for those staff at the heightened level of risk would be. Then there is the risk of transmission within that geographic space even if you manage to create an artificial barrier between the two.”
A DHSC spokesperson said: “Our priority is the prevention of infection in care homes and ensuring that everyone receives the right care, in the right place, at the right time. Building on the commitments of the adult social care winter plan, we are working with the CQC and the NHS to ensure that everyone discharged to a care home has an up-to-date Covid test result, with anyone who is Covid positive being discharged to a care home that CQC has assured is able to provide care and support for people who are Covid positive.”
Source: The Guardian
Keyword: English councils told to set up hundreds of Covid-dedicated care homes | Coronavirus outbreak