Guidance and information for Covid-19

Guidance and information for Retirement Community Operators in response to the Covid-19 pandemic: updated 03/04/2020 2.20pm

This page is intended to share government and other official guidance to ARCO members and others in the sector, and to provide analysis and updates which we believe will be useful to members and others responding to the Covid-19 pandemic. It does not constitute medical or legal advice. Members and others should continue to consult gov.uk and other official sources and to seek legal and/or medical/public health advice as appropriate. Reprinting or linking to external material does not constitute endorsement by ARCO.

 

CQC interim guidance on DBS and recruitment checks 2.20pm 03/04/2020

The Care Quality Commission (CQC) has published interim guidance on DBS and other recruitment checks, for providers recruiting staff and volunteers to health and social care services in response to Covid-19. The guidance has been published following the temporary changes made by the Disclosure and Barring Service (DBS) to DBS applications and processes, and will be in operation for the period the Coronavirus Act 2020 remains in force. 

The guidance applies to staff and volunteers being recruited as a consequence of and during the coronavirus pandemic, and where the following three things apply:

  1. Providers need to start staff urgently
  2. Waiting for a full DBS check could cause undue delay
  3. This delay could lead to risks to the continuity of service, impacting the safety and wellbeing of people using the service

If these three things apply, providers are offered a fast, free Barred List DBS check for emergency roles being recruited. The guidance emphasises the diligence that providers should continue to exercise around recruitment, and that new staff are sufficiently supervised and supported to ensure safety. 

ARCO comment: Retirement Community operators should now follow this new guidance from the CQC, but only where the three key criteria stated above apply to their recruitment. In all recruitment not linked to coronavirus and not meeting the three key criteria, operators are asked to follow existing DBS and CQC guidance. ARCO requests that members keep us up to date with any issues or challenges they experience with recruitment so that we can escalate these to the Department of Health and Social Care. Comment published 3 April 2.20pm 

 

Use of personal protective equipment (PPE) 12.50pm 03/04/2020 

 The Government has updated its guidance on infection control and prevention, including new guidance on the use of personal protective equipment (PPE) by health and social care workers. The main changes to the existing guidance on PPE are: 

  • Enhanced PPE recommendations for a wide range of health and social care contexts
  • Inclusion of individual and organisational risk assessment at local level to inform PPE use
  • Recommendation that some PPE items are used for single sessions
  • Recommendation that re-usable PPE can be used - advice should be obtained on suitable decontamination arrangements from the manufacturer, supplier or local infection control
  • Guidance for when case status is unknown and SARS-CoV-2 is circulating at high levels
  • Recommendations on the patient use of facemasks

The Government’s guidance contains further detail on all of these points, and more information on best practice, different types of PPE, risk assessment and patient use of PPE, among other things. Also included is a visual guide for safe use of PPE, and tables on the main guidance page summarising how different PPE items should be used. 

ARCO comment: All members should read this guidance – it also includes useful tables and diagrams (for example for PPE to be worn in different circumstances, best practice for hand washing) that can be put on display in staff areas/distributed to staff. We recognise that supplies of PPE continue to be problematic for the sector and we continue to raise this both individually and through the Care Provider Alliance.  The guidance also includes information on Occupational Health and Staff Deployment which is important reading for the protection of staff and residents.  Comment published 3 April 12:50pm. 

 

Admission and care of residents in a care home  12.50pm 03/04/2020 

The Government released new guidance yesterday for care homes, local health protection teams, local authorities, clinical commissioning groups (CCGs) and registered providers of accommodation for people who need personal or nursing care. The guidance sets out how to admit and care for residents safely, and how to protect staff. Seven key points are focused on in the document: 

  • Admission of residents
  • Caring for residents, depending on their Covid-19 status
  • Reporting of Covid-19 cases
  • Providing care after death
  • Advice for staff
  • Supporting existing residents that may require hospital care
  • National support available to implement this guidance

ARCO comment: This guidance has useful information on isolation and infection control that will be instructive to members – while recognising that the circumstances of a Retirement Community are different to those of a care home in important respects. We are expecting the Government to issue new guidance for domiciliary care providers shortly, and ARCO will continue to monitor this closely and update this compilation of guidance accordingly.  Comment published 3 April 12:50pm   

 

Guidance for Coronavirus Act 2020 4.00pm 02/04/2020 

The Coronavirus Act 2020 is now law. Key provisions for the sector include the following:

Section 15 and Schedule 12 to the Act (the “Care Act easements” provisions) were brought into force by Regulations on 31 March. Any members with local authority funded residents should be aware of these changes. The provisions release Local Authorities from the obligation to carry out Care Act-compliant care and support needs assessments or reviews, or carers’ assessments or reviews, and from the duty to meet eligible needs – replacing this with a power to meet needs subject to the requirement not to breach the person’s Convention rights as guaranteed in the Human Rights Act 1998. The NHS is also released from the duty to carry out NHS Continuing Healthcare assessments. The provisions are intended to allow Local Authorities to prioritise the delivery of the most urgent and most needed care and support to individuals during the Covid-19 pandemic.

The guidance accompanying the easements makes clear that Local Authorities should continue to comply with their pre-Care Act duties so far as is reasonably practicable but also that there may be new needs arising as the result of the Covid-19 outbreak – for example if a person’s family carer is unwell or other services are closed. The duty to carry out financial assessments is also subject to easement – Local Authorities will not be able to charge service users for services until the financial assessment has been completed, when they can then recoup charges for the period when no financial assessment had been carried out.

Other relevant provisions include a power to make regulations to allow the recovery of statutory sick pay for Covid-19 by employers and the temporary suspension of the usual three “waiting days” before SSP is paid; and powers to make orders to alter the rate of National Insurance contributions for employees, employers and the self-employed.  Further provisions of note include those simplifying and giving more flexibility in procedure for the registration of deaths, and allowing cremations to take place more quickly. The Act also builds on the Health Protection (Coronavirus) Regulations 2020 in granting powers to police and public health officers to enforce the screening and isolation of potentially infectious people.  Powers relating to the closure and restriction of premises, events and gatherings are also streamlined. 

Members with queries regarding the application of the Act and guidance should email Sally Ireland at sallyireland@arcouk.org.  Comment published 2 April 4.00pm 

 

House moves 10.20pm 31/03/2020 

Whilst Government guidance is clear that if possible, house moves should be arranged to take place outside of the lockdown period, there is a recognition that a small number of moves may need to go ahead.

In response to a letter from ARCO seeking clarification, The British Association of Removers have advised that in such circumstances:

  • Removers should honour their existing commitments where it is clear that the move can be done safely for the client and your own staff and it is clear that themoving date cannot be moved.
  • Removers should follow the latest Government guidance which currently states that work carried out in people’s homes can continue, provided the tradesperson is well and has no symptoms or coronavirus (COVID-19).
  • It is important to ensure Government guidelines are followed, including maintaining a 2 metre distance from others, and washing their hands with soap and water often for at least 20 seconds (or using hand sanitiser gel if soap and water is not available).

No work should be carried out by a person who has coronavirus (COVID-19) symptoms, however mild.

ARCO comment: Prospective residents and their movers should consider travelling with headed letters from their conveyancing solicitor and the Retirement Community operator confirming that this is the case. This will include cases where moving is unavoidable for contractual reasons and no new date can be agreed. We advise that people with symptoms, those who are self-isolating and those who are shielding do not move if possible. Mortgage lenders are working on ways to enable customers who have exchanged contracts to extend their mortgage offer for up to three months to allow for a later move date. We would also advise all members to read the specific guidance for estate agents.

This letter does however provide some level of reassurance that the British Association of Removers would not prevent their members carrying out moves in such circumstances and can be shared with removal companies if required. Comment updated 31 March 10.20pm

 

Simplified process for CQC registration and statement of purpose changes 2.50pm 25/03/2020

The Care Quality Commission (CQC) has streamlined and simplified its process for those providers needing to make a new CQC registration or to change their registration because of Covid-19. The CQC have also provided information on how providers can update their statement of purpose if necessary. 

ARCO comment: Providers are advised to read the full CQC update on what constitutes a Covid-19 registration, and to take any appropriate steps as soon as possible to complete their registration and update their statement of purpose, if necessary. Comment published 25 March 2.50pm 

 

Staying at home and staying away from others 1.15pm 24/03/2020

Last night the Prime Minister, Boris Johnson, announced new measures requiring people to stay at home and away from others, starting immediately and continuing for a minimum of three weeks. People should only leave the house for these reasons: 

  • Shopping for basic necessities like food and medicine, as infrequently as possible
  • One form of exercise a day
  • Any medical needs
  • Travelling to and from work if absolutely necessary

In addition, public gatherings of more than two people are to be stopped, and all non-essential shops and public spaces closed. Full details of businesses and premises that must close can be found here, but these include: 

  • Non-essential retail
  • Libraries, community centres and youth centres
  • Indoor and outdoor leisure facilities
  • Communal places within parks
  • Places of worship
  • Hotels and hostels

Environmental Health and Trading Standards officers will monitor compliance with these regulations, with police support provided if appropriate. Businesses and premises that breach them will be subject to prohibition notices, and potentially unlimited fines.  

ARCO comment: This represents a further tightening of restrictions on communal spaces including cafes and restaurants as well as indoor and outdoor leisure facilities. Operators should consider whether the actions they are taking regarding their communal facilities and services (indoors and outdoors) are in line with the stated intentions of government guidelines around social distancing and reducing social contacts to a minimum. Currently, outdoor communal areas may be considered to have a similar status to public parks and may be able to remain open – however, operators might want to consider peak demand and flow management to reduce overcrowding. Shops on site (both permanent and impromptu) may be permitted to continue to operate as they are providing essential food items to Retirement Community residents but advice should be sought from local authorities on this. Comment published 24 March 1.15pm 

 

Closure of businesses and venues 2.40pm 23/03/2020

On Sunday the Ministry of Housing, Communities and Local Government (MHCLG) issued an update on its regulation asking some businesses and venues to close. It said local government would be responsible for enforcing these regulations, with Environmental Health and Trading Standards Officers, with police support if appropriate, working together to issue prohibition notices when the restrictions are not followed.

The full restrictions – which had previously been announced and are detailed here - will not affect supermarkets or retailers that supply fuel, medicines and other vital goods, which will continue to be open as normal for the public. The following businesses and venues have been asked to close: 

  • Food and drink venues for consumption on-site, such as restaurants and cafes.
  • Drinking establishments, including pubs, bars, nightclubs.
  • Entertainment venues, including cinemas, theatres, concert halls, and bingo halls.
  • Museums and galleries.
  • Spas and massage parlours.
  • Casinos and betting shops.
  • All indoor leisure and sports facilities, including gyms.

Not included in these restrictions are cafes or canteens at hospitals, care homes or schools. 

This measure will also not impact the relaxation of planning rules announced earlier this week which will allow pubs and restaurants to operate as hot food takeaways during the coronavirus outbreak, which will help to support people who are staying at home through this period.

ARCO comment: Following the further rules announced by The Prime Minister on 23/03/2020, operators should consider whether the actions they are taking regarding their communal facilities and services (indoors and outdoors) are in line with the stated intentions of government guidelines around social distancing and reducing social contacts to a minimum. Currently, outdoor communal areas may be considered to have a similar status to public parks and may be able to remain open – however, operators might want to consider peak demand and flow management to reduce overcrowding. Shops on site (both permanent and impromptu) may be permitted to continue to operate as they are providing essential food items to Retirement Community residents but advice should be sought from local authorities on this. Comment updated 24 March 1.15pm

 

Financial support available to businesses 10.25am 22/03/2020

In a statement on Friday the Chancellor of the Exchequer announced an additional series of measures to support businesses and the economy during the coronavirus crisis. These include:

  • Employers will be able to contact HMRC for a grant to cover most of the wages of people who are not working but are furloughed and kept on payroll, rather than being laid off. Government grants will cover 80% of the salary of retained workers up to a total of £2,500 a month.
  • The Coronavirus Job Retention Scheme will cover the cost of wages backdated to March 1st and will be open initially for at least three months - and will be extended if necessary.
  • The Coronavirus Business Interruption Loan Scheme will now be interest free for twelve months.
  • Further measures to be announced this week to support credit
  • Deferring the next quarter of VAT payments and will have until the end of the financial year to repay those bills.
  • £1bn of support for renters, by increasing housing benefit so that the Local Housing Allowance will cover at least 30% of market rents in their area.

Earlier in the week the Chancellor had previously announced:

  • a Statutory Sick Pay relief package for SMEs
  • a 12-month business rates holiday for all retail, hospitality and leisure businesses in England
  • small business grant funding of £10,000 for all business in receipt of small business rate relief or rural rate relief
  • grant funding of £25,000 for retail, hospitality and leisure businesses with property with a rateable value between £15,000 and £51,000
  • the Coronavirus Business Interruption Loan Scheme offering loans of up to £5 million for SMEs through the British Business Bank
  • a new lending facility from the Bank of England to help support liquidity among larger firms, helping them bridge coronavirus disruption to their cash flows through loans
  • the HMRC Time To Pay Scheme

ARCO comment: Taken together these and previous measures, as well as the specific support for social care will help to partially mitigate the immediate financial pressure faced by some providers. ARCO will continue to escalate specific concerns arising from our sector directly to HM Treasury. Comment updated 22 March 10.25am

 

Government guidance on ‘supported living’ 9.20pm 19/03/2020

This guidance is aimed at local authorities, clinical commissioning groups (CCGs), community health services and providers of care and support delivered within supported living environments (people in their own homes)

ARCO comment: in the absence of sector specific guidance from the Government this appears to be the closest available to us. Comment updated 19 March 7.20pm

 

School closures  6.55pm 19/03/2020

It has been announced that after schools shut their gates from Friday afternoon, they will remain closed for most pupils until further notice. The statement has now been updated and makes it clear that care workers, support workers and specialist workers are categorised as critical workers who will still be able to send their children to school depending on local availability. Specific guidance has been issued for parents and carers. 

ARCO comment: The Government’s updated guidance now makes it clear who is classed as a critical worker, with care workers, support workers and specialist workers included and that  if needed school places will be provided if available. Critical workers are advised to contact their local authority should their child’s school have closed, or if they have questions about the health and safeguarding of pupils. From examples on the ground, it may be helpful for employers to supply their staff with letters clarifying the nature of the organisation’s work in this critical area of focus.  Comment updated: 24 March 1.15pm. 

 

Financial support for social care 6.15pm 19/03/2020

DHSC has announced that £1.6 billion will go to local authorities to help them respond to other coronavirus (COVID-19) pressures across all the services they deliver. This includes increasing support for the adult social care workforce and for services helping the most vulnerable, including homeless people. 

£1.3 billion will be used to enhance the NHS discharge process so patients who no longer need urgent treatment can return home safely and quickly. 

ARCO comment: While CQC-regulated parts of the Retirement Community sector are likely to be covered by this automatically, non-regulated provision of ‘support’ (rather than personal care) may not be picked up by the systems to be put in place. ARCO and others are trying to ensure that housing-related support functions in housing-settings (including Retirement Communities) are also covered by financial assistance being made available) Comment updated 19 March 6.15pm

 

Government guidance on domiciliary care 4.20pm 19/03/2020
This guidance covers steps for home care providers to maintain delivery of care; what to do if a care worker is concerned that they may have Covid-19; PPE, cleaning, and laundry procedures if a person being cared for has symptoms of Covid-19; procedures if neither the staff member nor the person being cared for has symptoms of Covid-19; NHS support for home care provision; Government support; and steps for local authorities to support home care provision. 

ARCO comment: There is currently no specific government guidance for Retirement Communities/housing with care settings for older people. Operators/their care delivery partners may wish to consider this guidance for their CQC registered domiciliary care services. Comment updated  19 March 4.20pm

 

Access to PPE  11.35am 19/03/2020
The Government has announced that every registered care provider (care homes and domiciliary care) will be receiving 300 face masks over the next few days (with a target of Tuesday). If care providers have immediate concerns over their supply of PPE, there is now a dedicated line: The National Supply Disruption line Tel: 0800 915 9964 Email: supplydisruptionservice@nhsbsa.nhs.uk

ARCO comment: Please note that providers receiving masks will be the registered providers of domiciliary care in a Retirement Community, and/or the care homes on the same site. Comment updated 25 March 1.35pm

 

Notifications to CQC 4.30pm 17/03/2020

CQC have clarified, in response to provider concerns, that there are no changes to the requirements to make notifications or the system used to make them. CQC-registered providers should notify CQC of deaths and of events that stop them carrying on their service “safely and properly” (regulation 18). CQC have clarified that this will mean letting them know if a provider’s service operation is being negatively affected by Covid-19. It does not mean that providers need to notify CQC of every single Covid-19 related issue.

ARCO comment: The ARCO team will continue our dialogue with CQC, both escalating member concerns as they arise and keeping CQC informed of the evolving situation. Comment published 17 March 4.30pm