Lancashire care homes invited to take Covid patients from hospital by creating safe areas

Care homes across Lancashire are being asked if they would be willing to accept Covid-positive patients being discharged from hospital – and segregate them from the rest of their residents.
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The government has told councils to try to identify providers able to safely house people with coronavirus who have either come from care homes originally or are unable to return to their own homes.

However, only a handful of the more 400 care homes in the county have so far volunteered for the so-called “designated settings” scheme.

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To be a designated setting, a care home would need to demonstrate that it could it could isolate infected individuals – a capability which would be confirmed as part of an enhanced inspection by the regulator the Care Quality Commission.

Currently, only two providers have completed that process, with a small number of others having expressed an interest.

Sue Lott, Lancashire County Council’s head of adult social care, told a meeting of the authority’s health scrutiny committee that there was not “a huge appetite from the care market” for the idea.

“You really have to be able to zone [Covid-positive] people away from the rest of the residents – so either on a separate floor or wing and, where possible, have a separate entrance as well.

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“For a number of our care homes…their environment [means] they wouldn’t be able to apply. But for those who are able to meet those environmental regulations…we’re working very closely with them around the infection prevention control measures that they would need to take,” Ms. Lott said.

The care sector nationally was devastated during the early weeks of the pandemic after around 16,000 people were discharged into homes without being tested for Covid.

Committee member and Chorley councillor Margaret France – a retired GP – said reassurance would be needed that that there were “no connecting doors or mechanisms by which a confused person with Covid could make their way into another part of the building, potentially infecting others”.

Papers presented to the meeting also revealed that there is a “significant” hospital bed deficit across Lancashire and that the NHS is looking to create between 250 and 300 places both in hospitals and care homes, although these were likely to be for Covid-free patients, the committee heard.

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The county council’s annual adult social care winter plan is dominated by Covid concerns this year – and is built upon £7.7m of grant funding to expand capacity, including the recruitment of additional staff.

However, the committee was told that if the additional services commissioned to cope with winter – the plan for which usually runs until the end of March – were required to continue throughout the first half of the next financial year, another £4.3m would need to be found.

Measures outlined in the plan include a requirement to ensure individuals are tested for Covid prior being discharged from hospital – to address the issues from the first wave – and the implantation of a standardised discharge process across Lancashire.

Continued cash support will be available to the care sector to help restrict the movement of agency staff between different homes and so reduce the risk of infection, while the county council’s own temporary staffing agency will be maintained – at a cost of £50,000 per month – to provide a further fallback to cover staff shortages. Workers will require a negative Covid test before they can be deployed to a new setting.

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Care homes will also continue to receive daily support calls from County Hall staff to check if they need additional help and to keep track of any needs as a result of Covid outbreaks.

Sue Lott described the work being undertaken as “a juggling act” and told the committee that keeping people in their own homes as far as possible – and out of hospital or care settings – would be another main focus of the months ahead.

An additional 1,600 hours of crisis support will be on offer to those who would otherwise be at risk of hospitalisation – with individuals eligible for anything between a one-off hour up to three days of continuous help.

Similarly, 3,000 hours will be made available for people who may be able to avoid care home admission with extra support, while additional overnight help will be offered to those who need checks, but not continuous monitoring.