Recommendation 51

HM Government · verbatim extract Accepted

The government partially accepts this recommendation. IPC is a core part of delivering adult social care. Guidance has been updated throughout the pandemic to reflect the importance of IPC, and DHSC published updated IPC guidance on 31 March 202224 to set out the next phase of the response in adult social care. The updated ‘Every Action Counts’25 toolkit was published in March 2021, which provides a suite of resources for care homes and visitors to support the delivery of infection prevention and control. A wide range of training on IPC is available to the sector. On 11 November 2021, DHSC launched the IPC Champions Network for Adult Social Care, led by the Chief Nurse for Adult Social Care. To accompany this launch, DHSC created a Good Practice Guide detailing examples of IPC measures and best practice across various care settings. The government undertakes exercises regularly, both at a national and local level, as they are an essential part of assessing both its pandemic preparedness and its planning for a wide range of scenarios. The lessons learned from exercises and incidents are integrated into the government’s preparedness plans. For example, 2016’s Exercise Cygnus was a Tier 1 national exercise that considered the implications of responding to an influenza pandemic, the highest-rated risk on the NRR. The lessons learned from Exercise Cygnus informed a workplan that was taken forward across government by the Pandemic Flu Readiness Board. Specific guidance for local resilience forums on preparations for a pandemic is published online.26 While there is no expectation that individual care homes will need to conduct regular pandemic preparedness drills, local authorities will need to satisfy themselves and work with local providers to ensure they are appropriately undertaking contingency and business continuity planning. 24 Infection prevention and control: resource for adult social care – GOV.UK (https://www.gov.uk/government/publications/infection-prevention-and-control-in-adult-social-care- settings/infection-prevention-and-control-resource-for-adult-social-care) 25 Every Action Counts Toolkit – CARE (https://www.skillsforcare.org.uk/resources/documents/Developing-your-workforce/Care- topics/Infection-prevention-and-control/Every-Action-Counts/Every-Action-Counts-Toolkit.pdf) 26 National Resilience Standards for Local Resilience Forums – GOV.UK (https://www.gov.uk/government/publications/national-resilience-standards-for-local-resilience-forums- lrfs) DHSC provides guidance on isolation in care homes, however this does not explicitly mean care homes must have dedicated isolation facilities, as this may not always be practical given the variation in layout and facilities within these settings. Designated settings were set up to ensure that, during the peak of the pandemic, no COVID-positive patient would be discharged into a care home; rather they would go to a designated setting that would provide appropriate care throughout their period of isolation before they could be safely transferred to a care home. Designated settings played an important role during the second wave of the pandemic in helping to prevent the incursion of COVID-19 infection into care homes. Over the summer of 2021, DHSC conducted a review of designated settings policy with key stakeholders, including the Care Quality Commission (CQC), the Local Government Association, sector representative organisations, and individual providers, as part of its preparations for winter. Their feedback informed the policy direction for designated settings, ensuring that the scheme met local needs. Funding for designated settings and the Designated Settings Indemnity Support Scheme was in place until 31 March 2022. Updated IPC guidance now outlines that care homes can admit residents discharged from hospital who have tested positive for COVID-19, if the home is satisfied that they can care for them safely. The guidance also outlines that those who have tested positive should be isolated from other residents and, where possible, have separate staff dedicated to their care. DHSC’s visiting guidance (incorporated into the IPC guidance published on 31 March 2022) also provides detail on how providers can enable safe visiting, including: lateral flow testing visitors carrying out personal care (up to twice weekly); twice weekly lateral flow testing of care staff; guidance on appropriate use of PPE, and guidance on IPC measures such as hand hygiene, ventilation, and distancing from other residents. The guidance makes it clear that visiting is crucial to residents’ wellbeing and mental and physical health, and that visiting should be supported in all circumstances. Clinical advice is regularly reviewed, and guidance updated to reflect the latest advice. As care recipients in adult social care remain at greater risk of hospitalisation and death from COVID-19 relative to the general population, and as the transmission risk remains high in vulnerable settings