To: All care providers Local Authority Chief Executives and Directors of Adult Social Care Dear care colleague, Actions required to prevent rise in coronavirus cases in the care sector

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To: All care providers Local Authority Chief Executives and Directors of Adult Social Care

Dear care colleague,

Actions required to prevent rise in coronavirus cases in the care sector

You will know already that we are experiencing a rise in confirmed COVID-19 cases, across the UK population. I need to alert you to the first signs this rise is being reflected in care homes too.

Over the past 3 days, Public Health England (PHE) has reported an increase in notifications of COVID-19 cases in care homes. Testing data has also shown an increase in the number of positive results. Currently, the infections are mainly affecting the workforce but clearly there is a risk the virus will spread to care home residents, or to other parts of the care sector.

Unfortunately, in some care homes with recent outbreaks, this does appear to have occurred, with residents also becoming infected.

I am writing at the earliest opportunity, so we can work in partnership to prevent further spread of the disease. The rapid flow of data and information, to and from care providers, is vital to this effort.

We would not be in a position to respond so quickly without your vital input to the capacity tracker and the domiciliary care tracker and your committed efforts to implement regular testing. By sharing this alert, we hope local organisations can now take the necessary action to prevent and limit outbreaks.

We want to express our heartfelt thanks for your enormous efforts, care and vigilance to date. It is precisely these qualities that will stand us in good stead throughout the autumn and winter months.

We will shortly publish our Adult Social Care Winter Plan, following the excellent work of the Adult Social Care COVID-19 Taskforce. The plan will set out the support and resources we will make available nationally, as well as describing the actions for local areas.

In advance of the plan’s publication and at these first signs of an increase in COVID-19 cases in care homes, I want to highlight again the importance of regular testing and consistent use of PPE.

These are 2 of the most effective ways to stop the virus in its tracks. Please also ensure that you are putting in place best practice infection prevention control practices such as restricting staff movement, set out in the care homes guidance.

Testing

Testing in all care homes is vital to protecting residents and staff and is an important part of the national effort to tackle COVID-19. If we know where the virus is, we can take steps to prevent transmission.

Therefore, in line with the national testing strategy:

  • to detect and prevent viral transmission to and from the community, all care home staff (including bank and agency staff), including those without symptoms, should be tested every week
  • it is important to test staff regularly to tackle the risk that the virus may be brought into a care setting from within the community. By making sure all staff in care homes are getting tested every week, we can find out who may have coronavirus and stop it before it spreads. Further information regarding regular testing and how to order tests is available.

We recognise that rollout of the repeat testing programme for care homes was unfortunately delayed. However, tests have now been delivered to all care homes for older people who registered for regular testing and the portal is now also open for care homes for working age adults to register for repeat testing. At present, we have no significant backlog and are able to send out test kits within several days of orders being placed.

We encourage care homes that have not yet registered for repeat testing to do so. If for any reason you have not registered to receive the most recent set of tests for which you are eligible, please do so, and please be sure to use tests you have received in line with the guidance.

Please be aware that care homes do not automatically receive their next round of regular testing and so each care home needs to reorder towards the end of each round of testing. Care homes are able to reapply 21 days after their last order.

In response to concerns raised with us about turnaround times, we have taken action to address the issue, including a new process for prioritising care home tests in laboratories. We will continue to monitor this closely and take further action if needed.

Please immediately contact your local Health Protection Team (HPT) if you suspect your care home has a new coronavirus outbreak (one or more suspected or confirmed cases of COVID-19). Your HPT will support a public health risk assessment and enable urgent whole home testing through pillar 1 if an outbreak is suspected.

Any member of social care staff who develops symptoms should immediately self isolate and order a test. Adult social care staff are on the list of essential workers prioritised for testing if they have symptoms. Please refer any staff for testing if they are self-isolating because either they or member(s) of their household have coronavirus symptoms and share testing guidance with them.

Personal protective equipment (PPE)

While tests will identify the COVID-19 virus, it is possible that staff or residents could become infected prior to the virus being detected. It is also possible that a test can return a false negative result, for example if the amount of virus present is too small to be detected or a member of staff may become COVID-positive in between weekly tests.

For these reasons, the correct and consistent use of PPE is very important. Please make sure you and your staff are following the PHE guidance relating to PPE:

Winter

This winter will place unique pressures on the health and care system. COVID-19 will be co-circulating with seasonal flu and other viruses, and transmission may increase over the winter period. The government is committed to working closely with you to make sure we are prepared for additional pressures.

I would like to express my thanks again to you and to all your staff for your ongoing hard work. Your commitment, compassion and dedication is hugely appreciated.

Yours sincerely,

Stuart Miller Director of Adult Social Care Delivery Department of Health and Social Care

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Learn More:

  • Fears grow for care homes as coronavirus cases rise across UK. Government urges care providers to take action to stop spread of virus among residents – The Guardian
    • Concerns are growing over an increase in Covid-19 cases in care homes in England, prompting the government to send an alert to care providers to highlight the rising rates and to call for action. The letter, sent on Friday, urges care bosses to “take the necessary action to prevent and limit outbreaks”, pointing out that in the last three days there had been an increase in notifications of coronavirus cases in care homes. At the moment it is the workforce that is most affected, but the letter says that “clearly” there is a risk that the virus will spread to residents and in some cases already has. The letter, which was written by Stuart Miller, the director of adult social care delivery at the Department of Health and Social Care, said: “You will know already that we are experiencing a rise in confirmed Covid-19 cases, across the UK population. I need to alert you to the first signs this rise is being reflected in care homes too. “Over the past three days, Public Health England (PHE) has reported an increase in notifications of Covid-19 cases in care homes. Testing data has also shown an increase in the number of positive results. “Currently, the infections are mainly affecting the workforce but clearly there is a risk the virus will spread to care home residents, or to other parts of the care sector. Unfortunately, in some care homes with recent outbreaks, this does appear to have occurred, with residents also becoming infected.” The Sunday Times reported a Department of Health report marked “official sensitive” and circulated on Friday said that the rate of coronavirus recorded through satellite tests – which are used in care homes – had quadrupled since the start of the month.
  • Coronavirus cases in care homes spiral again. Matt Hancock admits new risk to residents. – The Sunday Times
    • The coronavirus is spreading through care homes again, according to leaked documents that show the government is failing to protect the most vulnerable from the spiralling number of cases. A Department of Health report marked “official sensitive” and circulated on Friday stated that the rate of the coronavirus recorded through satellite tests — almost all of which take place in care homes — had quadrupled since the start of the month. It now stands at an estimated 1,100 new cases every day. Matt Hancock, the health secretary, took an emergency update on Wednesday saying that outbreaks had been detected in 43 care homes after months of calm.