During the coronavirus pandemic, we’re working differently so we can welcome new Residents, provide safe visits for loved ones and protect those who already live and work with us.
We are really pleased to be able to open our homes up in many ways as the COVID-19 situation improves and the restrictions ease. This includes the ability to welcome prospective Residents and families to visit our care homes prior to making the really important decision about their own or their loved one’s care.
For those who would like to book a viewing, they can do so in a number of different ways, either via contacting our friendly Careline Team on 0333 999 8699, direct with the home or through our electronic booking tool, accessed via the individual home’s page on our website. You will be advised upon booking what to expect on arrival, the infection control measures that are in place and guidance to follow during your visit. Whilst you will be shown the key aspects of the home, we still need to ensure the safety of everyone in our homes, therefore the areas you will be shown will be limited, but you will still experience the best possible sense of the home.
Our robust admissions policy forms our ‘caring through coronavirus care planning approach’ which is designed to offer the safest and kindest possible way to start to live life in a care home, during these challenging times.
Before a new Resident moves into one of our care homes, we will carry out an in-depth assessment of their needs and personal preferences and they will receive a coronavirus test, which will usually be carried out in their home, community setting or hospital.
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. This will consider any monitored self-isolation undertaken prior to admission to the care home, the levels of transmission in the community within which the previous care home or care facility is situated and the COVID-19 management of the previous care home or care facility.
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.
The description of an essential care giver is “a loved one who provides a greater degree of personal care or support, to maintain a Resident’s immediate health and wellbeing.”
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.
The Resident will be subject to an enhanced testing regime consisting of a PCR test before admission (within 72 hours), a PCR test on the day of admission (day 0) and a further PCR test 7 days following admission (day 7) and daily rapid lateral flow testing until the day 7 PCR test has been received.
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, where a Resident is being admitted from hospital and has recently recovered from COVID-19, as PCR testing can take several weeks to revert back to a negative test result due to persistence of non-viable viral RNA remnants, repeat PCR testing within 90 days of a COVID-19 diagnosis in preparation for discharge will be considered carefully.
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 risk assessment prior to hospital discharge for Residents with a non COVID-19 diagnosis will be completed in partnership with the care home.
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.
All admissions of Residents from the community, regardless of Protection Level, should have one negative PCR test within 3 days of their admission date.
In exceptional circumstances, where testing is not possible before admission to the care home, then testing upon admission to the care home will be considered.
Where it is shown to be in the clinical interest of the Resident and providing a negative test is not feasible, an agreed care plan for admission to the care home will document this.
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.
The risk assessment will include factors such as the presence of COVID-19 related symptoms, the COVID-19 status of the household they have come from, the Resident’s travel history, the Residents vaccination status, care home Colleagues vaccination uptake rate, general IPC and PPE training, supplies and usage in the care home.
In all cases (except where a Resident has recently tested COVID-19 positive), loved ones may still be able to visit the Resident during their 14-day isolation period through essential visits. These visits will be considered where isolation could impact the Resident’s wellbeing or where additional support would help the Resident through the settling in process.
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
In Wales, new Residents who are admitted to a care home from hospital will require Residents to be tested upon being discharged from hospital to the care home unless they fall under the following criteria:
- The Resident has tested positive and were treated for COVID-19 during their hospital stay, more than 20 days have passed since they tested positive and the Resident is now well.
- The Resident has tested positive for COVID-19 within the last 90 days.
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.
Testing can be accessed through a home test kit; booking a test at a local community testing centre or via the Health Board.
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.
Residents do not require testing in advance of discharge from a residential setting back to their own home in the community unless they are in receipt of a social care package.
For more information on the Welsh Government’s guidance visit: Care homes and social services: coronavirus | GOV.WALES