Admission of Residents from hospital, from an interim care facility or transferring from another care home
In England, new Residents upon admission where they have been discharged from hospital, from an interim care facility or are transferring from another care home will receive in-room care and hotel services for a period of 14 days before they move into the wider care home community.
However, where Residents are admitted from a care facility or another care home, Care Home Managers will undertake a risk assessment which will consider the need for the Resident to receive in-room care and hotel services for a period of 14 days before they move into the wider care home community. During this 14 day period, essential care givers are welcome to visit Residents in their rooms and Residents will be supported to leave their room to go outdoors if they wish to do so and if the care home has outside space, without restarting their 14 day isolation period, unless there are specific reasons not to do so. For example, if the Resident has tested positive for COVID-19 or is symptomatic.
Admission of Residents from the local community
New Residents in England who are admitted from the local community do not need to isolate for 14 days upon admission where they meet certain requirements and specific criteria are met. This includes:
- Where the Resident is fully vaccinated (and the admission is a minimum of three weeks after their 2nd dose of the vaccine to ensure maximum immunity).
- Guidance from the local Director of Public Health about community transmission of Variants of Concern is followed.
- The Resident has no known contact with a COVID-19 positive individual.
- The care home has considered the circumstances at the Resident’s home prior to admission to the care home.
For more information on the Government guidance visit: Admission and care of residents in a care home during COVID-19 - GOV.UK (www.gov.uk)
Admission of COVID-19 recovered Residents from hospital
In Scotland, COVID-19 recovered Residents can be discharged from hospital into the care home after 14 days from symptom onset (or their first positive test, if asymptomatic) without further testing. In these situations, discharge at 14 days is based on clinical judgment of fitness for discharge. This decision will be made in collaboration with the Care Home Manager who will need to agree to the Resident’s transfer before this takes place.
If a COVID-19 recovered Resident has completed their 14 days of isolation in hospital, no further isolation should be required on their return to the care home.
If a COVID-19 recovered Resident is discharged to the care home before their 14 day isolation period has ended, they will be required to have two negative PCR tests before discharge from hospital. The tests will be required to be taken at least 24 hours apart. If the Resident has not completed their 14 day isolation then they will receive in-room care and hotel services in the care home. They will not be required to start a new period of isolation, nor do they require further testing. Where it is shown to be in the clinical interest of the Resident and negative testing is not possible, a risk assessment a care plan for the remaining period of isolation, up to 14 days in the care home will be agreed upon.
Admission of non COVID-19 Residents from hospital
In Scotland, all non COVID-19 Residents that are discharged from hospital will be required to receive in-room care and hotel services for a 14 day period from or including the date of discharge from hospital.
A single negative COVID-19 test result should be preferably available within 48 hours prior to discharge from hospital into the care home. The exception to this is where a Resident is considered to suffer distress or clinical consequence if they were not able to be discharged to a care home. In these situations, the Resident may be able to be discharged to the care home prior to the test result being available (whether the result is positive or negative). However, the 14 day isolation period where the Resident will receive in-room care and hotel services before they move into the wider care home community must be completed in the care home regardless.
Admission of Residents from the community
In Scotland, for new Residents who are admitted to the care home from the community, the 14 day self-isolation requirement will follow a Protection Level approach set out by the Scottish Government.
Protection Levels 0-2
In Protection Levels 0-2, a risk assessment will be agreed on a case by case basis by the Care Home Manager to determine whether the Resident will receive in-room care and hotel services upon admission to the care home. This decision will be at the Care Home Manager’s discretion, subject to local risk assessment as guided by the local oversight group.
Protection Levels 3-4
In Protection Levels 3-4, the Resident will receive in-room care and hotel services upon admission to the care home for 14 days before they move into the wider care home community. A risk assessment will be completed prior to admission to ensure that appropriate isolation facilities are available and will consider requirements for the Resident’s care.
For more information on the Scottish Government’s guidance visit: COVID-19 - information and guidance for care home settings (adults and older people) - version 2.2 - COVID-19 - information and guidance for care home settings (adults and older people) - Publications - Public Health Scotland
Admission of Residents from hospital
As per Welsh Government guidance, Residents will not be admitted to the care home if they are infectious. Whilst testing before admission to a care home is helpful, the most important step to prevent the spread of infection is for the Resident to receive in-room care and hotel services upon admission to the care home for 14 days following discharge from hospital before they move into the wider care home community.
Where a Resident has already completed a 14 day isolation period in an alternative facility prior to admission such as a step down service, further isolation may not be essential. A risk assessment will be carried out by the Home Manager which will take into consideration whether a further period of isolation will be required as a precaution or not. Testing before discharge from these settings will still be required.
Admission of Residents from the local community
Welsh Government policy is that all Residents should be tested prior to admission or placement unless they have previously tested positive within the last 90 days.
If a Resident tests positive for COVID-19 or has symptoms, placement or admission should be delayed for 10 days or (14 days for those in clinically vulnerable or extremely clinically vulnerable groups) or until symptoms have resolved whichever is the longer.
If a Resident has been identified as a contact of a COVID-19 positive individual or someone with symptoms consistent with COVID-19 infection they should remain in household isolation in their current home until the end of the 14 day self-isolation period.
As our homes care for those who are clinically vulnerable or extremely clinically vulnerable, a period of isolation on arrival in the setting is advised, for 14 days, as a negative test result does not rule out infection as an individual can already be incubating the virus at the time of the test or become infected after they were tested.
If a Resident has been fully vaccinated then a period of isolation is not necessary after a negative test.
In the event of a clinically or extremely clinically vulnerable individual requiring admission without a test result e.g. in a situation where it was unsafe for them to remain at home, they should be admitted to an appropriate 'step-up' care facility that is able to provide appropriate isolation and they should be treated as a COVID-19 positive individual until the outcome of any test result is known.
For more information on the Welsh Government’s guidance visit: Care homes and social services: coronavirus | GOV.WALES
Residents’ bedrooms are homely and comfortably furnished with all the necessary facilities and comforts to relax and take advantage of in-room care and hotel services provided by Colleagues who are tested routinely.
This is a great opportunity for new Residents to get to know the Colleagues who will support them whilst they receive in-room care and hotel services and gain a greater understanding about life in the care home.