Coronavirus (COVID-19) Update

Latest Issue:  w/c 18 May 2020

Morris Care endeavours to promote and maintain the safety and well-being of our residents and staff. The information in this document is Morris Care’s current actions to manage coronavirus (COVID-19) and its possible impact on the services provided by Morris Care.

This document will remain under review as new information is released by Public Health England (PHE) about COVID-19.

Morris Care Emergency Group (MEG) has been operating for some weeks now to oversee all activity within Morris Care Ltd during the COVID 19 pandemic.  The group is chaired by the CEO on a weekly basis and includes all members of the senior leadership team to ensure that all colleagues are up to date with issues in all the homes, manage risk, give direction on key issues and ensure that all our residents remain safe and well cared for.

MEG discuss and make decisions based on fundamental clinical practices, staffing deployment, supply chain of PPE, recruitment and volunteers working and supporting the homes.  It also manages internal communications to staff members including staff appreciation and external messaging to family and friends as well as any other relevant COVID matters. The Home Managers are maintaining a proactive and transparent approach in liaising with various local and national government agencies, including the Care Quality Commission.

Local Authority teams have confirmed regarding the government initiative on testing of all residents and staff, including those with no symptoms. The briefing included identification in terms of testing pathways (referrals, testing sites, formal training arrangements to equip care home staff with the correct swabbing techniques for home testing kits).

Residents

We have postponed any planned events in the homes, that are often attended or facilitated by people from the community. Social Life Co-ordinators are supported by the home team and the volunteers to facilitate meaningful activities for our residents on a day-to-day basis.

All non-essential outings or appointments from the home have been suspended

Continuous promotion of stringent hand and respiratory hygiene practices

Careful monitoring of residents’ health and well-being: minimum of twice daily temperature checks (template to record information will be provided) and any other clinical observations determined by the individual’s clinical risk factors. Wherever possible, a tympanic thermometer must be used when taking residents’ temperature.

Social distancing measures must be followed for everyone in the home, wherever possible. Staff should implement the shielding measures for those residents who fall under the category of extremely vulnerable (room isolation with good ventilation; use of the appropriate PPE for any staff going into the room to protect the resident).

Anticipatory medications (steroids, antibiotic) must be considered to be made available for those residents who are considered at higher risk due to their existing medical conditions.

The nursing team must be proactive in reviewing the residents’ GSF status and promptly discuss with their families and the GP any significant changes to their general condition. Residents who are on palliative care must have anticipatory medications available.

All residents in the home are expected to be supported with their future wishes. Advanced care planning must be initiated and discussed with the residents and/or their family members or appointed attorneys. The nursing team must liaise with the GP to review the residents’ ReSPECT form (if applicable) and their resuscitation status.

New admissions: follow MORRIS CARE ADMISSION PROTOCOL DOCUMENT

New admissions will stay in their own rooms for the first fourteen (14) days with nursing and care team completing careful monitoring to identify any developing coronavirus symptoms using appropriate standard Personal Protective Equipment for all care interventions as advised by Public Health England

Admission of residents who are not able to comply (significant cognitive impairment and are mobile) with the 14-day room isolation must be comprehensively assessed. Liaise with the nominated Facilitator or Clinical Governance and Innovations Manager.

SYMPTOMATIC RESIDENTS:

In the event of any resident presenting with any typical or atypical symptoms of suspected coronavirus (COVID-19), such as: cough, fever, breathlessness, sudden onset of anxiety, delirium, agitation, confusion; fatigue, muscle ache, headache, hoarseness, nasal discharge or congestion; sore throat, wheezing, sneezing, reduced alertness, reduced mobility, diarrhoea:   the resident will be isolated in their own rooms (14 days) and all associated control measures will be implemented as per Public Health England’s guidelines, including update request of testing as per local protocol.

Suspected outbreak (2 or more cases within 14-day period): Home Managers will need to consider cohorting of affected residents with dedicated staff team.

Residents tracker is in place which is completed and updated by the homes. A simplified tracker is also submitted to central team on a weekly basis

A discreet sign (gerbera) will be placed by the bedroom door of those affected residents to ensure all staff adhere to the appropriate PPE and IPC practices.

If cohorting is not possible, ensure that the resident on isolation is scheduled as the last one for any intervention within one session. This is to ensure sessional use PPE is utilised effectively. Discard/Decontaminate PPE after intervention with resident on isolation.

This process also applies to all nursing interventions (meds, wound care, other clinical duties). For time-sensitive medications, complete a risk assessment and liaise with the GP or meds mgt team for any concerns.

 

Morris Care Staff

Communication has been cascaded to strict adherence to continued Infection Prevention and Control Practices is expected from all staff working in the homes, with emphasis on effective hand hygiene, appropriate use and removal of personal protective equipment, daily care practices within the residents’ rooms, and disposal methods.

Follow Morris Care PPE Guideline Document which is constantly reviewed and updated in line with the current local and national government guidance

Staff are required to adhere to the Morris Care guidance with the use of appropriate PPE and availability of easy-guide poster from Shropshire, T&W local IPC team as a daily guide: https://www.spic.co.uk/resource-category/advice-on-infection-prevention-control-and-ppe/

 

Relevant staff must demonstrate competence in the use of PPE (donning and doffing) evidenced by a return demonstration which will be recorded and filed accordingly. The assessment will be facilitated by the nursing team.

Individual and group supervisions must be completed for all staff regarding appropriate Infection Control Precautions. Emphasis on daily hand-over, spot checks and clear, easy posters are ways to ensure staff are supported to fully understand the underpinning principles of the mandatory practices in the homes.

A dedicated “PPE donning area” must be allocated within the cohorted corridor (or outside of the affected resident’s room) with all the required PPE (fluid repellent surgical mask, gloves, aprons, face shield, small black bags, pedal bin with orange bag (to dispose used masks) and hand gel.

Follow guidance on when to use respirator (FFP2/FFP3) and coveralls.

All external training has been suspended. Provision of in-house training is implemented.

Staff are also required to have their temperature checked and recorded before commencing their shift. They are required to inform the nurse-in-charge without delay if they are feeling unwell whilst on-shift.

Following the update from Public Health England on 16 March 2020, communications have been cascaded to all employees of Morris Care Ltd. detailing instructions when reporting potential absence from work.

Nominated First Point of Contact personnel were identified for each Morris Care home to receive calls from employees reporting symptoms of potential coronavirus (COVID-19) infection or employees sharing a household with someone who has symptoms of potential coronavirus infection. Staff are expected to keep in contact with their home manager, in line with the company’s attendance policy.

Staff who:

and has access to the internet, must get an isolation note and send to your manager as proof that you need to stay off work (link: https://111.nhs.uk/isolation-note/)

COVID 19 TESTING:

Staff or a member of their household is either symptomatic/tested (+) for COVID:

Contact the home as outlined above.

The home manager or nominated individual will complete required information and will notify the staff member that details will be shared to Single Point of Referral Service, who will contact the staff member directly and confirm eligibility for COVID 19 testing.

A live record of all incidents of absence from work-related to symptoms of potential coronavirus will be maintained. Staff tracker is submitted to Central Team on a weekly basis

HR Team provided an aide-memoir to assist the managers with various coronavirus-related queries from staff

All employees who are over 70 or are pregnant, were advised not to attend work until further advice received from Public Health England.

All employees identified by PHE that fall into the category of being extremely vulnerable group due to underlying health condition will receive a letter from the NHS with advice to follow the shielding measures, including staying at home at all times and avoiding face-to-face contact for at least 12 weeks. Staff who are in this category are expected to provide their home manager a copy of this letter.

HR Team are assisting the home managers to identify and contact relevant staff members who are considered eligible for furlough

 •Employees who have had medical advice to ‘shield’ in line with public health guidance and have evidence from the NHS or their GP

•Those who we have instructed to refrain from work as they are classed as vulnerable – over 70’s, pregnant, underlying health conditions

Agencies: Communications have been cascaded to all agencies supplying temporary staffing in all Morris Care homes regarding our actions to promote and maintain the health and well-being of our residents and our staff. In addition, Morris Care Ltd requested that agencies share their own business continuity plan in response to the coronavirus situation.

In the event of unprecedented staffing shortage, the team will assess and will be deployed appropriately to ensure critical needs of our residents are met with an acknowledgment that periods of inconvenience may occur.

-Each Morris Care home will undertake a skills audit to identify which staff are willing and able to work additional shifts, work night duty or work in different departments

-Management team will consider deployment of staff from non-direct departments (administration, catering, support team) to assist with the residents’ daily needs alongside the care team

- Agency usage: home management team to consider temporary arrangements with agencies that are providing temporary workers in the homes to “block book” their staff, whilst maintaining mutual agreement that these agency staff members will not work elsewhere.

Overseas nurses who have received a letter from the Nursing and Midwifery Council inviting them to temporarily register will be fully supported to enable them to carry out nursing duties whilst adhering to the conditions identified by the NMC.

 

Visitors

 

Letters were issued to all Next of Kin requesting support of our aim to minimise the risks along with health promotion advice.

Visits to the home are restricted to essential visits only. Any family members/Next of Kin wishing to visit must liaise and arrange it with the home manager. Assistive technology is facilitated to support communication between the residents and their loved ones.

Morris Care official website and social media platforms are updated all the time to reflect various activities in all of our homes. It also involves updated news and information as another communication tool to families in addition to the telephone, emails and video calls.

Essential visits to the home (ie for those residents who are on end of life care) must follow Infection Control Practices, including appropriate donning and doffing of PPE.

Follow VISITING PROTOCOL DOCUMENT

Door entry control was implemented.

All visiting professionals, with exception of the external medical team, is suspended until further notice with remote discussions and reviews facilitated by assistive technology.

External contractors will be restricted to emergency repairs and those that pose significant health and safety risks

 

Essential refurbishment works will only be considered to specific location in the homes that can be accessed directly from the outside and will not involve resident areas, including corridors frequented by direct home staff and residents.

Any supply deliveries will be made to the exterior of the building.  Home administrators will verbally acknowledge receipt of the items.

 

Supplies

Additional supplies of hygiene and environmental products have been ordered. Balance of stocks is monitored.

A pooling of central stocks has been established facilitated by a nominated individual who is liaising with the homes’ administrators and guided by the CEO.

Home management to maintain communications with other supply chain providers to identify any disruption to any products and agree to suitable alternatives, whilst liaising with the company’s nominated individual.

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