Coronavirus: council service information and advice

Information about changes to council services as a result of coronavirus

Whole home testing - August 2020 Update

The DHSC Whole care Homes Testing roll out is currently experiencing delays. The delays are due to the recall of the Randox swabs following safety concerns.

DHSC are hoping to have the delays sorted by early September to begin the next phase of the programme. We are also aware that some care homes are experiencing delays in receiving test results back.

Please keep raising your concerns via the whole care home testing email address at COVIDCareHomeTestingReferrals@dhsc.gov.uk.

Watch daily whole care home testing webinars

Information for care homes

There is a lot of information available to support care homes. It's being updated regularly, so we'll be saving updates and signposting to the latest guidance from this portal:

National Capacity Tracker for Care Homes

All homes should be signed up to the National Capacity Tracker and entering data on at least a daily basis.

The Coronavirus support for care homes support package sets out the support that is available to your care home during the COVID-19 pandemic that helps to protect your residents and staff. 

This support is being provided through access to effective infection control training/support, clinical support and testing for asymptomatic residents and staff. Local authorities are being asked to ensure that this support reaches you directly and to ensure this happens. To do that, we're asking you to complete a template confirming the actions you are taking.

To implement this, and to avoid multiple requests for information, the capacity tracker is now collecting information on:

  • infection prevention and control measures
  • testing
  • Personal protective equipment (PPE) and clinical equipment
  • workforce support 
  • clinical support.

    Please can you ensure you are completing all sections daily, or more often when any response changes.

Your answers will help:

  • the NHS to understand if you have been able to implement the guidance and access the support available.
  • local authorities to direct support to care homes to manage COVID-19 
  • local authorities, local resilience forums and CCGs to see where support is required and what is needed. 

Home managers are now also asked to enter data on new laboratory confirmed or clinically suspected cases of COVID-19 infection in either residents or staff on the Capacity Tracker every day.  

Covid 19 positive resident numbers need to be removed from the capacity tracker once the home has passed 28 days from the date of the last suspected / confirmed case. At this point the home is considered 'recovered'.

Once past the 28 day marker this will trigger the home back into the Covid 19 retesting regime and it is expected the home will undertake whole home testing for those who have tested negative previously and then weekly testing of staff.

This data will be used by Local Authority Directors of Public Health and Directors of Adult Social Services and their partners, local Health Protection Teams, Clinical Commissioning Groups, and care homes themselves to understand how effectively any identified outbreaks are being controlled and what further help and support may be needed.

NHSmail accounts

NHSmail has been set up for social care providers, to enable the secure exchange of patient or sensitive information with other health and social care organisations.

With the active use of NHSmail we wanted to provide you with some support to manage the account and help with any frequently asked questions (FAQs) you may have.

NHSmail FAQs

What to do if you are joining a social care provider and require an NHSmail account?

  • If you do not have an NHSmail account you will need to inform the shared mailbox owner for your new provider. This is likely to be the organisation’s manager or administrator. This can be setup by another individual at the specific home who has an account already. Most homes when setting up have 2 individuals designated as connected to the homes shared mailbox.
  • You will need to provide them with your personal mobile phone number, as your password will be sent to you via a text message. The existing NHS mail account holder will need to login to their own account and open up the shared mailbox.
    From that shared mailbox account they need to send an email to careadmin@nhs.net and ask for a new account to be setup for that particular home with the following details:
  •      First name and surname of the person needing the new account
  •      The job role of the new person (so for your specific enquiry new registered manager)
  •      An email address for the incoming person (can be personal email but this is where the setup stuff is sent)
  •      A mobile phone number for the incoming person (as the unlocking password is sent to this by text message)
  •      NHS Digital will do all the setup work on the new account and email & text the details to the new person usually within 24 hours.

What do I need to do if I’m moving to another provider or leaving social care altogether?

If your account is administered by the national administration service team:

  • If you are leaving your organisation you will need to notify the national helpdesk via careadmin@nhs.net . They will mark your NHSmail account as a ‘leaver’ and ensure that you are removed from any shared mailboxes you no longer need access to.
  • If you are moving to another health or social care organisation you will also need to inform the national helpdesk. This is so that they can mark your NHSmail account as a ‘joiner’ and ensure that you are added to the shared mailbox of your new organisation, if needed.
  • If you are leaving the social care profession and no longer require an NHSmail account, your account will be permanently deleted 30 days after being marked as a ‘leaver’. You should ensure any data required by your team is saved locally, for them to access at a later date.
  • If you are a shared mailbox owner, you will need to ensure a new owner is identified and the national helpdesk are informed.
  • Update: Changes to shared mailbox names 

Telemedicine service 

Telemedicine service

Immedicare provides the Telemedicine Service which was first introduced in Portsmouth in December 2019. Since the first introduction to a small number of homes, additional homes across the City are now benefiting from accessing the great service.  

During this time, almost 300 calls have been made. Following a telemedicine consultation 90% residents were able to remain in their home (with just 9% requiring an ambulance call out).

We would like to raise awareness and encourage you to use the service whenever you need any additional reassurance, advice, or that bit of extra help and support for your residents and staff team.

When should I use the Telemedicine service?

You can phone and speak to a member of the team if you need reassurance, help or support. You can phone any time you feel that something “isn’t quite right” with your resident, you know them best.

Some examples are below:

  • Falls, slips, trips  
  • Suspected UTI’s/ Chest infections 
  • Wound care 
  • Breathing difficulties 
  • Pain management
  • Skin complaints; localised infection or swelling 
  • Assist in verifying an expected death of a resident

Please remember the Telemedicine service is not an emergency service. If you have an emergency you should still call 999.

Please be assured that no question is a ‘silly’ or ‘small’ question. The Telemedicine Service is here to enhance the care that you deliver.

What are the benefits of calling the Telemedicine Service?

There are a number of benefits to you, your team and the residents when you use the Telemedicine Service. 

The Telemedicine Service aims to:

  • Support care homes to make joint decisions, resulting in residents (if possible) remaining in their own home and being cared for by someone they know.
  • Provide ongoing support and reassurance for staff and the resident when required.
  • Coordinate care and any referrals with the other health care professionals.
  • Reduce avoidable GP call outs, 111 calls, and ambulance or A+E attendances 

What are people saying about the Telemedicine Service?

Positive feedback has been collected over the last few weeks which shows the benefits of the service.

GP Partner Trafalgar Medical Group Practice and Director Portsmouth Primary Care Alliance Ltd, Dr Howard Smith says:
“Feedback from our existing telehealth users has been very positive – staff in our Care Homes have video access 7 days a week, 24 hours a day to Specialist nurses and Doctors who have full access to residents medical records. The service provides timely clinical assessments meaning residents can receive the right care at the in the right place and unnecessary delays and conveyances to hospital can be avoided”

Caroline Berry, Registered Manager, Russets Respite and Residential Services says:
“We found it (Telemedicine service) very helpful and easy to use. There has been great support to the team at Russets on how and when to use it. It’s also good to know that it is available for us to have face to face consultations and seek advice when we need that extra support.”

If you would like any more information about the Telemedicine Service, please contact Paula Grundy (Immedicare – Telemedicine Service). Paula is your local Relationship Manager for SE Hampshire. 
You can contact her Monday through to Thursday by:

Telemedicine- Support for ambulance crews attending care homes

Across Portsmouth and South East Hampshire, South Central Ambulance Service (SCAS) and the Telemedicine Service Provider for Care Homes (Immedicare) have developed a formal pathway to provide ambulance clinicians with multi-disciplinary support when attending residents in Care Homes. Please see the attached information.

Families and visitors  

Guidance on visitors coming into care homes

The Government has released guidance on enabling visitors to residents in care homes:

Portsmouth City Council and Portsmouth CCG have developed some tools to support you to carry out whole home and resident risk assessments for enabling visits to residents. There is also a template policy included which can be adapted and shared with residents, staff and visitors.

The Relatives & Residents Association and the National Care Forum has set out shared expectations and good practice relating to the importance of clear, open, transparent and regular communications during the COVID-19 crisis between care providers and the families of their residents.

This has been endorsed in a joint statement on communication expectations by the Care Provider Alliance, the Care Quality Commission and Skills for Care and should be considered by all providers throughout their response to the pandemic.

Portsmouth City Council have developed a risk assessment tool to help keep workers visiting people in their homes safe

Testing

IMPORTANT SAFETY INFORMATION

A message from DHSC: - Randox test Kits - 7 August 2020

On July 16 we wrote to all care homes who had received Randox test kits from NHS Test and Trace, instructing them to immediately cease using these kits for testing.

This pause in the use of Randox test kits was a precautionary measure while we investigated a potential safety issue that we had been made aware of. In our communication, we asked all care homes to keep their test kits in a secure location and ensure they are not used.

The Medical Health products Regulatory Agency have taken the decision to recall Randox test kits as a precautionary measure. For the full recall statement please visit: https://www.gov.uk/government/news/update-on-randox-test-kits--2

Anyone who is in possession of Randox test kits should follow the instructions on how to return kits to Randox. We will be in contact with you next week to support you with labelling your kits and booking your courier.

This only affects care homes with Randox test kits, which are clearly marked with the words “Randox Laboratories”.

 Unsafe swabs – Citotest swabs batch 200032

The government has identified an issue with some swabs issued to care homes. Any Citotest swabs, batch number 200032, must not be used for testing. Care homes have been emailed details of how to identify these swabs, please check your stock before carrying out any further testing. All other swabs are safe to use.

The swabs that should not be used look like this and have the batch number 200032 

test swab 960

 

Information from the government about testing can be found  here .

Routine testing:

  • Accessed via digital portal
  • All staff (including bank, agency and visiting staff (e.g. social workers, allied health professionals) – weekly
  • All residents – monthly

Ordering routine tests:

  • All tests need to be ordered from the digital portal
  • The portal is currently open for around 9,000 homes for the over 65’s and those with dementia. Extra Care and Supported Living will be added from September 7th
  • You will receive enough testing kits to carry out 4x staff testing and 1x resident testing (i.e. 28 days’ supply of test kits)

Outbreak testing:

  • Accessed via HIOW Health Protection Team (HPT) at Public Health England
    • In hours: 0344 225 3861 option 2
    • Out of hours: 0844 967 0082
  • HPT can authorise whole home testing (staff and residents) via the Community Testing Service (CTS will drop off and collect swabs – homes will need to complete their own testing)
  • Repeat testing at 4-7 days of all staff and residents who screened negative via the Community Testing Service (CTS will drop off and collect swabs – homes will need to complete their own testing)
  • Repeat whole home testing at 28 days to confirm end of outbreak via the digital portal
  • It is important that the different tests you have in stock are not used for testing routes than the one they were supplied for to avoid delays and errors in processing.
  • Care Home staff who are self-isolating,  because a member of their household has symptoms, should continue to use the self-referral website to book a home test or an appointment at a test site.
  • Domiciliary care staff who need a test should also continue to use the self-referral website to request a home test or book an appointment at a test site.

 

How to complete the Care Home Capacity Tracker

COVID-19 positive resident numbers need to be removed from the capacity tracker once the home has passed 28 days (not 14 as previously stated) from the date of the last suspected / confirmed case. At this point the home is considered 'recovered'.

Once past the 28 day marker this will trigger the home back into the retesting regime and it is expected the home will undertake whole home testing for those who have tested negative previously and then weekly testing of staff.

How to apply the MCA to whole home testing

Homes carrying out COVID-19 testing need to ensure that they abide by relevant legislation and standards for consent and the Mental Capacity Act. The government has developed guidance to support this.

Consent means a resident must give permission before they receive any type of medical treatment, test or examination. For consent to be valid, it must be voluntary and informed, and the resident consenting must have the capacity to make the decision.

The meanings of these terms are:

  • voluntary – the decision to either consent or not to consent to testing must be made by the resident, and must not be influenced by pressure from staff, friends or family
  • informed – the resident must be given all of the information about what the test involves, including the benefits and risks, alternatives, and what will happen if test does not go ahead
  • capacity – the resident must be capable of giving consent, which means they understand the information given to them and can use it to make an informed decision.

If a resident has the capacity to make a voluntary and informed decision to consent to or refuse the test, their decision must be respected.

  • Consent can be given verbally or in writing. A resident could also give non-verbal consent, as long as they understand what is about to take place – for example, by allowing a throat/nose swab to be taken
  • As a minimum, homes should record in their records that a resident with capacity gave verbal consent for COVID-19 testing. Homes may wish to record this on a consent form and ask the resident to sign it

If a resident does not have the capacity to make a decision about testing and they have not appointed a lasting power of attorney (LPA), care home staff should act in their best interests. Staff must take reasonable steps to discuss the situation with the resident’s friends or relatives before making these decisions.

Key principles:

  • Homes should record a Mental Capacity Act assessment for the resident – the assessment should be time and decision specific around whether the resident wishes to have a COVID-19 test. The Hampshire MCA toolkit can support staff to make this assessment
  • No-one else can consent on behalf of the resident, including GP’s. However, others can inform and contribute to a best interests decision
  • The best interests decision should weigh the positive benefits to the resident of having a COVID-19 swab (for example, no longer having to be isolated, excluding COVID-19 as a diagnosis if they are unwell) versus the negative effects (for example, distress and discomfort, risk of harm if the resident bites the swab)
  • The MCA assessment and Best Interests Decision must be clearly documented in the care records for future reference
  • Every decision must be an individual assessment for each resident and episode of testing as situations and circumstances may change

Homes should not feel under pressure to swab residents who lack capacity to make a decision on testing if they conclude that it is not in their best interests.

Test and Trace

It is critical that all providers follow the guidance contained in How to Work Safely in Care Homes and How to work safely in domiciliary care to reduce the risk to residents from the spread of COVID-19 and also avoid unnecessary staff isolation.

It is vitally important that all staff continue to follow social distancing guidance. This includes socially distancing from each other as well as residents and not taking breaks together or sharing offices in close proximity without wearing face-coverings.

It also includes not sharing cars to work where possible and wearing face masks whilst working in all areas of the home.

Whole Home Testing - practice example

We are aware that the requirement for care homes to carry out weekly testing of all staff presents significant challenges. Whilst we all support the aim to keep COVID-19 out of our care homes and away from vulnerable residents, many homes have struggled with the capacity and workforce needed to deliver this (aside from issues around supply and collection).

One care home in Hampshire has shared how it has managed the process and empowered staff to own and deliver their own testing without impacting the day to day running of the home.

Key to the homes success has been:

  • allowing staff to take responsibility for their own tests
  • supporting staff early on with training around taking an effective swab.

In summary, the home:

  • provides each staff member at the beginning of each month with 4 swabs to undertake weekly testing
  • trained all staff using their clinical team to manage their own personal swabs
  • implemented a fixed collection day (in this case Monday) and allowed staff to either swab themselves on a Sunday evening or Monday morning and bring to swab in to work
  • provided staff with details to allow them to register their own swabs – using a generic nhs.net email address and phone number so that all results come back to the care home manager for distribution and management
  • set up a dedicated computer terminal in the home for staff to register swabs onsite if they don’t have access at home
  • included contractors that work with the home and also some families who have continued to provide personal care services during the pandemic in the programme.

The effect is that all staff (clinical and non-clinical) proactively manage their own weekly testing with minimal input from management and at no additional time pressure to the organisation.

Information for Supported Living Providers

This guidance is designed to update and build on the previous advice to supported living providers, which was withdrawn on 13 May 2020.

It sets out:

Guidance on infection prevention, control, supply and use of Personal Protective Equipment (PPE) 

IPC guidance

 
CQC: infection, prevention and control in care homes 

We previously introduced how we are looking at infection prevention and control (IPC) in care homes. We have now published our new IPC inspection tool on our website.

As we increase targeted and focused inspections of high risk services, this tool will be used to look at how well staff and people who live in the care home are protected by the prevention and control of infection (Key Line of Enquiry S5). Over time, we will look to improve and adapt the tool for other types of services.

The tool will help us to gather information about the strengths of a service and to understand if there are any gaps or concerns around IPC where we can signpost to resources which could help. 

We all plan to manage any risk of a second wave of the coronavirus and the impact of winter pressures. This helpful tool is something you can use to prepare.

PPE in care homes

We currently remain in a period of sustained transmission. Requirements for PPE in care homes during sustained transmission are set out in: How to work safely in care homes.

The key general summary on PPE use is:

  • When providing direct care (contact) or when within 2 meters of a symptomatic resident – full PPE (apron, fluid repellent surgical face mask, gloves) is required with a risk assessment around eye protection
  • When within 2 meters of a resident who has no symptoms but not performing direct care (contact) or touching them, and there is no one within 2 metres who has a cough - fluid repellent surgical face mask

When working in communal areas where you may be within 2 meters of a resident on occasions - fluid repellent surgical face mask (note that all symptomatic residents should be isolated)

    When you're 2 metres or more from a resident you should be wearing a Type I or Type II surgical mask. This includes staff not in a caring role e.g. cleaners, receptionists and when not in direct proximity to residents e.g. in staff only areas.

If you work alone in an office you will not be expected to wear a mask but when you leave the private work area to move through the care home building, e.g. on an errand, or for meal breaks, you should put on a surgical mask (Type I or II)

      This is assuming care workers are not undertaking aerosol generating procedures, information on that is below.

PPE in domiciliary care settings

We currently remain in a period of sustained transmission. Requirements for PPE in domiciliary care settings during sustained transmission are set out in: How to work safely in domiciliary care

The key general summary on wearing PPE is:

  • When providing personal care in direct contact with client – full PPE apron, fluid repellent surgical face mask, gloves) is required with a risk assessment around eye protection
  • Whenin the client’s property but not performing direct care- wear a surgical mask
  • Always risk assess the need to wear eye protection eg. When there is the potential for splash back.
  • Where there is more than one client in the household , gloves and aprons will need to be changed between each episode of care
  • Symptomatic patients could be asked to wear a surgical mask where tolerated.
  • When you are within 2 metres of anyone in the household who is coughing, even if not providing care to them- full PPE (apron, fluid repellent surgical face mask, gloves) is required with a risk assessment around eye protection
  • If you have been giving personal care to clients and you are changing your work duties e.g. going to your organisation’s office, then you need to remove your face mask, clean your hands and then put on a new Type l or Type ll face mask
  • If you share workspace/working environment (e.g. including the office, staff communal areas and dining rooms) with care workers who care for clients then everyone in that workspace including yourself will need to wear a Type I or Type II face mask. If you do not share workspace or working environment with care workers who care for clients (e.g. if care workers are in a different office or part of building with no shared communal areas) then you do not need to wear a face mask. If you do work in a separate (e.g. private) office but share communal areas (e.g. dining room) with care workers then you would need to wear a Type I or Type II face mask in those communal areas.

•    Sessional use refers to wearing masks and eye protection continuously until you take a break or the session ends (e.g. leaving one household)

•    Where you need to remove your mask (e.g. to take a drink or eat) then you need to dispose of it safely. Do not dangle your mask or eye protection around your neck. Do not re-use your mask

•    Where there is a shortage of FRSM FFP2 masks can be used; where there is an acute shortage of FRSM and FFP2 masks a non-fluid resistant mask can be worn with a full face visor.

This is assuming care workers are not undertaking aerosol generating procedures, information on that is below.

Aerosol Generating Procedures

Please be aware that that there are some aerosol generating medical procedures that might be in use in care homes and other community settings. These include CPAP and BiPAP machines, (sometimes used to treat the symptoms of sleep apnoea). There are additional PPE requirements that need to be considered in these circumstances where care is being provided to a person while they are using the equipment and up to an hour after it has been switched off.

These include the use of gowns and FFP3 masks. FFP3 masks must be fit tested to ensure an appropriate fit and training in the doffing and donning of PPE should be provided. If you are supporting someone who uses this type of equipment please contact the health care professional who is supporting the service user to discuss this further. If you have a service user using other equipment and you are not sure if this is aerosol generating again please contact the health care professional for clarification.

Public Health England provide a list of Aerosol Generating Procedures.

Update:

The current position of PHE is that suctioning of the oral cavity in front of the pharynx*, where you can still see the tip of the yankeur sucker or catheter does not constitute an AGP. If suction is past the pharynx, this could generate aerosols and although the risk is felt to be low it does constitute an AGP.

*The pharynx (plural: pharynges) is the part of the throat behind the mouth and nasal cavity, and above the oesophagus (food tube) and larynx. 

If you feel you are conducting AGP’s your staff will need to be fit tested for safe use of FFP3 masks. You can contact the Quality Improvement Team at Pccg.qualityimprovementteam@nhs.net to discuss how this fit testing can be arranged.

Demonstration of donning and doffing PPE.

Skills for Care SE IPC WhatsApp Group and Weekly Webinar

The Infection Prevention and Control leads in the South East group aims to provide a forum where IPC leads can support each other, share resources and ask questions.

The network is open to:

  • All staff who take responsibility for infection, prevention and control for their organisation. Each week, if questions have not been answered by the group and support from
  • NHS/Improvement Team and Public Health England these are addressed at the weekly webinar.

If you would like to join the closed WhatsApp group and would like details for the Infection, Prevention and Control webinars please email your contact details, care organisation, mobile number to Debbie.boys@skillsforcare.org.uk Skills for Care Locality Manager, Southampton, Hampshire, IOW and Portsmouth. Your details will not be shared with third parties.

Information about PPE supply

Over the last few months, the market regarding the provision of personal and protective equipment (PPE) has been very dynamic.  In Portsmouth, mechanisms have been developed to support providers by ensuring that additional PPE purchases that you need to make because of the Covid-19 pandemic are reimbursed, and to provide emergency supplies.

We are now in a stable position in the city with stocks of PPE and supply lines, so we are keen to ensure that we provide the most efficient processes and best value for money for the city. 

For these reasons, we would like to encourage providers to consider, when looking to purchase PPE for which you would otherwise submit a claim for reimbursement, to consider approaching PCC in the first instance for stocks, through the PPE@portsmouthcc.gov.uk inbox 'How to access PPE' guide using order form PPE order form

If you utilise the PCC stock, you will not need to submit a claim for reimbursement via ContrOCC. We carry as standard:

  • Masks (Type IIR)
  • Gloves
  • Aprons
  • Face visors and goggles

    There are some items where there are still challenges in the market, and this includes gowns and FFP3 masks, which we are still struggling to secure, so for these items we will still only be able to support emergency supplies.

At all times, providers should continue to take advantage of other supply opportunities, including by using the national PPE portal and working with wholesalers where there are relationships or opportunities, for example, Wightman and Parrish who will supply to CQC registered addresses.

Please ensure that you regularly update the NHS Capacity Tracker with information about your PPE status. We use this information to help inform us of where to target our contact with providers to offer support.

Healthcare providers can order additional personal protective equipment (PPE) through the portal to top up their existing supplies for COVID-19 in an emergency.


Additional PPE support for care home providers

If you are a current customer of Wightman and Parish (W&P), you can call their Customer Service line (01323 445001) to place an order for gloves, up to 1000 units (1 case 10x100) per week. Wightman & Parrish also have a stock of aprons and masks that can be accessed where residents are showing symptoms of Covid-19 (see below).

You will need to be calling on a weekly basis as gloves cannot currently be accessed via the W&P website. All gloves will be delivered directly to settings, and cannot be sent to a central distribution centre.

If you are not a current customer of W&P, you cannot access this particular line of support, although other suppliers may put similar arrangements in place.

However, where a care home identifies they have residents with Covid 19 they can call the customer service number for W&P as they are an approved body under PHE. The care homes do not need to go through the PHE process and when they call W&P they will be taken through a list of questions about the current circumstances at the home before determining an allocation of gloves, aprons and masks.

Currently for each Covid patient in a home W&P will allocate sufficient stock i.e. 10 gloves, aprons and masks per day per resident. However, W&P will be looking at whether the care home has access to other stocks in determining whether they can supply additional equipment to these homes.

PPE Equipment Safety Information

Considerations for acute personal protective equipment (PPE) shortages  

The World Health Organisation clearly states that each of these measures carries significant risks and limitations and thus should be considered only as a last resort when all other strategies for rational and appropriate use and procurement of PPE have been exhausted.

Further clarification on the guidance has been provided from local infection prevention specialists. 
- In summary:

  • This is not a business as usual option and should only be used when extreme shortages of supply occur
  • Gloves and aprons are not to be re-used
  • Eye protection (single use) can be re-used. The standard method of cleaning is to use a detergent product or combined product as agreed by local IPC specialists
  • It is indicated that some facemasks could be re-used by carefully folding them so that the outer surface is held inward and against itself to reduce likely contact with the outer surface during storage, then storing the mask between uses in a clean sealable bag/ box which is marked with the person’s name and is then properly stored in a well-defined place. This guidance appears to relate to FFP2, FFP3 and N95 masks and not fluid repellent surgical facemasks.
  • Fluid Repellent Surgical Facemask should continue to be:
  • Any re-use of masks should clearly balance the risk of not having any mask to wear during direct care versus the risk of cross-infection.
  • disposed of if they become moist, damaged, visibly soiled
  • Used as sessional equipment - sessional use is dependent on local (e.g., heat, activity length, shift-length) and individual factors; in practice, this may vary from 2hrs up to 6hrs
  • disposed of if the mask is removed for any reason (for example, upon exiting a COVID-19 area, taking a break, completing a shift).

    Disposal of used PPE

Used PPE should be stored securely within disposable rubbish bags, placed into another bag and kept separate from other waste. This should be put aside for at least 72 hours before being put in the usual disposal bin.

Pressure damage from wearing PPE

Guidance for staff has been published around the prevention of facial skin damage beneath personal protective equipment (PPE). Advice includes:

  • keeping your skin clean and well hydrated/moisturised
  • applying creams at least 30 minutes before applying PPE (Caution: skin protectants and emollients with white soft paraffin are flammable. You are advised not to smoke with them present on your skin)
  • Considering the use of a barrier skin wipe/skin protectant if you are likely to be wearing PPE for extended periods
  • Taking time to fit your mask before starting a shift/procedure. Ensure all folds in your mask have been used to optimise the correct fit for you and do not over-tighten
  • Regularly inspecting your skin for signs of redness/soreness
  • Taking regular breaks (we recommend every two hours) from wearing a mask to relieve the pressure and reduce moisture build-up
  • Staying well hydrated throughout the day.

Useful links

Home visits

We want to minimise any risk to the health and social care workforce, including those who visit customers or service users in their own homes.

To help with this, we have introduced a new coronavirus risk assessment that staff should complete along with the normal risk assessment specific to your job.

Access to Care and Health Information Exchange

Part of the local CCGs’ digital initiatives to support service providers

Care and Health Information Exchange (CHIE) is a shared care record which is simple to navigate and holds data for ALL patients registered to a Hampshire and Isle of Wight GP practices.

To access CHIE from within your care home setting, you will require a PC or a laptop with web browser software installed (e.g. Internet Explorer or Chrome) and a user account for each individual staff member who will be accessing the system.

Access to CHIE will enable you to see the following:

  • GP information including medical history, medications, diagnoses and allergies.
  • Discharge summaries from Hampshire Hospitals, University Hospitals Southampton and Portsmouth Hospitals Trusts.
  • Radiology and pathology reports from the above Trusts including (COVID-19 status)
  • Community and Mental Health Service Information from Southern Health NHS Foundation Trust, Solent NHS Trust
  • Adult Social Care information from Hampshire County Council, Southampton City Council

    Next steps

If you would like access to CHIE in your care home, please email Sally Manger:  sally.manger@nhs.net with the following information for each member of staff for whom you are requesting access:

  • Job title
  • Contact email for user account creation
  • Phone number

    Each staff member will be contacted and supplied with a user name and password and details of how to reach the log on page and copies of user guides (including top tips).

CHIE is a read-only, web based system that is very easy to navigate and requires no 1:1 training.

Staff are asked to accept the T&Cs and acknowledge the following:

Acceptable user agreement

“I will ensure that where practical, as a care professional, I will ask the patient before accessing CHIE for patient care. If the patient is unconscious or not present but would benefit from my care, I may use my judgement about accessing the information and will record my reason for doing so.”

The registered manager (or nominated deputy) will also be asked to sign and return a Data Sharing Agreement.

Training and e-learning modules

New guidance on training from Skills for Care

Following Government advice on returning to work, Skills for Care have updated their face-to-face training and assessment guidance. The guidance is  available for employers, learning providers and in-house trainers during COVID-19.

The guidance encourages digital solutions to deliver and access training. If digital solutions are not possible, then the guidance recommends and assists you to develop a thorough risk assessment. This will ensure any face to face training you assess as needed by staff can be carried out with minimal risk for all involved.

Visit the Skills for Care website to read the guidance in full.


e-Learning for healthcare

Health Education England programme in partnership with the NHS and professional bodies has launched an e-learning module called Coronavirus (COVID 19):


Grey Matter Learning

A free e-Learning course has been launched - Coronavirus (COVID-19) Essentials:


Free Skills for Care webinars

If you’d like to join one of the webinars, please register using the links below. A limited number of places are available but the webinars will be recorded and hosted on Skills for Care website for viewing.  

Each webinar will last 30 minutes. If you have any questions on the topic that you’d like to see raised, please email these to  events@skillsforcare.org.uk

Business support

Businesses affected by coronavirus that would like some help and support on how to proceed in the current climate can now access Portsmouth City Council's dedicated helpline. Please call 023 9284 1641 Monday to Friday, 7am - 7pm to speak to our economic growth team. They can help businesses navigate the wide range of support that is available.

Employee support 

The government as well as many public and private organisation have some additional support, advice or offers in place, to support employees in adult social care professionals during these challenging times.

Mental health and wellbeing

There are some simple things you can do to look after your mental health and wellbeing at the current time. Looking after your mind and body will help you both at work and home.   

  • Remember that it is OK to struggle at the present time. Everyone reacts differently and you may feel different emotions at different stages of the pandemic. However, it may cause you to feel worried, stressed, sad, scared or helpless – these are understandable feelings.
  • Take time to look after your physical wellbeing – this will have a big impact on how you feel emotionally. Taking breaks at work, maintaining a routine, eating well and exercising can help.
  • Think about what has helped you cope in the past to cope with stressful situations. Focus on what is in your control, try to pace yourself and remember that this will not last forever.
  • Extend the self-compassion and care you have for others for yourself .
  • Look after your emotional health. After difficult or stressful experiences at work, it is normal for memories or images of what has happened to come into your mind. Try to let these memories come and go rather than blocking them or trying not to think about them. Try not to stay focused on difficult thoughts and feelings – using some of the resources below can help.

    Getting help and support
  • Reach out to colleagues, friends or family members for support
  • Text messaging support service by Shout. Text 85258 or find out more
  • Health and wellbeing information for social care workers: advice, tips and tools on how to manage stress and wellbeing by LGA and NHS.
  • Mental health support for social care workers: Mental Health at Work offer round-the-clock, one-to-one support, along with a collection of resources, tips and ideas chosen to support the mental health of social care workers.
  • General health and wellbeing advice for residents, including Every Mind Matters.
  • Help for Heroes have developed a useful resource for health and care staff
  • Hospice UK run a bereavement and trauma support line - call 0300 303 4434 between 8am and 8pm, seven days a week to talk to a trained professional for support. They're there for all adult social care workers that have experienced a bereavement, witnessed traumatic deaths at work or would like to talk to a trained professionals about any emotional distress experienced as a result of the coronavirus epidemic.
  • A practical guide by the Community Care Inform Team on developing emotional resilience and wellbeing. If you are pushed for time and want to jump straight to techniques and tools to try, go to the final section: What can I do to enhance my resilience? (page 17).
  • Make use of local resources such as chaplaincy services, professional membership organisations, unions, employee assistance programmes and others 
  • Although it is normal to find what is happening emotionally difficult (for example, you may experience bad dreams or feel anxious), look out for signs of feeling emotionally exhausted, tearful, overwhelmed or low – these feelings are a cue to get support including telling your manager how you are feeling
  • Find an IAPT Service. Most people won’t need to access psychological therapies, but it is important to get help if you need it. If you have been exposed to highly stressful, traumatic or frightening experiences at work, you are more likely to develop post-traumatic stress disorder (PTSD). Symptoms include reliving what has happened through vivid dreams or flashbacks, feeling very anxious, angry, irritable and guilty. Some people will feel low in mood, have trouble sleeping and have physical symptoms. For many people, these symptoms will improve over time, but if they don’t improve after one month, you can be referred or self refer for psychological therapy. Services will also work with you if you are suffering from depression or anxiety.

Samaritans support line: Samaritans has launched a new confidential support line for NHS and social care workers. Volunteers are there to support and listen when you've had a tough day, are feeling worried or overwhelemed, or just have a lot on your mind and need to talk it through. You can call the free confidential support line on: 0800 069 6222 (7am to 11pm, 7 days a week).


Social care workers app

The Department of Health and Social Care has launched a social care workers App: The purpose of the app is to:

  • act as a one-stop-shop, providing the sector with all the latest guidance, wellbeing support and advice they need to protect themselves from COVID-19 and keep themselves well
  • provide access to learning resources on crucial areas such as infection control as well as practical advice and support for mental wellbeing
  • show how care workers can take advantage of offers available to NHS and social care staff, including free car parking and discounts through organisations and initiatives like Discounts for Carers and the Blue Light Card
  • signpost free access to apps like Silvercloud, Daylight and Sleepio, which can help boost users’ mental wellbeing through programmes covering sleep, stress and resilience

A video introducing the app can be found here.

Other support available for key workers