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{{org_field_name}}

Registration Number: {{org_field_registration_no}}

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COVID-19 Management Policy

1. Purpose

The purpose of this policy is to set out how {{org_field_name}} will prevent, identify and manage COVID-19 and other acute respiratory infections while protecting the health, safety, dignity, rights and wellbeing of people we support, staff and visitors.

COVID-19 is managed within the national approach to acute respiratory infections. This policy must therefore be implemented alongside {{org_field_name}}’s Infection Prevention and Control Policy and the current infection prevention and control guidance for adult social care published by the Department of Health and Social Care and the UK Health Security Agency.

{{org_field_name}} will take a proportionate and risk-based approach to infection prevention and control and will not impose blanket restrictions where risks can reasonably be managed through less restrictive measures.

This policy aims to:

• prevent and reduce the transmission of COVID-19 and other acute respiratory infections;
• ensure that people who develop symptoms are identified promptly, monitored appropriately and receive clinical assessment or treatment where required;
• protect people at increased risk of serious illness while maintaining person-centred care, dignity, choice, independence and social contact;
• apply standard infection control precautions at all times and additional precautions where indicated by an individual or outbreak risk assessment;
• ensure that personal protective equipment is used in accordance with current national guidance and risk assessment;
• ensure that testing is undertaken only where recommended by current national guidance, a healthcare professional, the UKHSA Health Protection Team or another authorised public health body;
• recognise and respond promptly to a suspected outbreak of acute respiratory infection;
• maintain safe staffing and continuity of care during infection outbreaks;
• facilitate visiting and visits out in accordance with Regulation 9A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; and
• support eligible people and staff to access vaccination and eligible people to access appropriate COVID-19 or influenza treatment promptly.

2. Scope

This policy applies to:

• All staff, including permanent, agency, and voluntary workers.
• People we support, ensuring their care needs are met safely.
• Visitors, contractors, and external healthcare professionals entering the care home.
• Management and leadership teams, responsible for overseeing compliance.

3. Legal and Regulatory Compliance

{{org_field_name}} will comply with applicable health and social care legislation and regulatory requirements when preventing and managing COVID-19 and other acute respiratory infections.

The principal requirements relevant to this policy include:

• Health and Social Care Act 2008 – establishes the regulatory framework for health and adult social care services in England and the powers and functions of the Care Quality Commission.
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 9 – Person-centred care – care and treatment must be appropriate, meet the person’s needs and reflect their preferences.
• Regulation 9A – Visiting and accompanying in care homes, hospitals and hospices – people living in the care home must be facilitated to receive visits and must not be discouraged from taking visits out of the care home unless exceptional circumstances apply. Any precautions or restrictions must be necessary, proportionate, risk based and the least restrictive option available.
• Regulation 10 – Dignity and respect – people must be treated with dignity and respect, including when additional infection prevention and control measures are required.
• Regulation 11 – Need for consent – care and treatment, including infection-control interventions where consent is required, must be provided with the consent of the relevant person or otherwise in accordance with applicable mental-capacity legislation.
• Regulation 12 – Safe care and treatment – the provider must assess risks to people’s health and safety and do all that is reasonably practicable to mitigate those risks. This includes preventing, detecting and controlling the spread of infections.
• Regulation 15 – Premises and equipment – premises and equipment must be clean, secure, suitable for their intended purpose, properly used and properly maintained.
• Regulation 17 – Good governance – effective systems and processes must be maintained to assess, monitor and improve the quality and safety of services and to maintain accurate records relating to infection prevention and control.
• Regulation 18 – Staffing – sufficient numbers of suitably qualified, competent, skilled and experienced staff must be deployed and staff must receive the support, training, professional development, supervision and appraisal necessary to carry out their duties safely.
• Care Quality Commission (Registration) Regulations 2009 – statutory notifications must be submitted to the Care Quality Commission where an event meets a notification requirement. A single COVID-19 case does not automatically constitute a requirement to notify the CQC solely because the person has tested positive.
• Health Protection (Notification) Regulations 2010 – applicable statutory public-health notification and reporting requirements must be followed, including requirements relating to test results where they apply.
• Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance – the provider will have regard to the Code when determining its systems for preventing and controlling infection.
• Health and Safety at Work etc. Act 1974 and associated health and safety legislation – {{org_field_name}} will assess and manage risks to employees and others arising from work activities, including occupational exposure to infection.
• Mental Capacity Act 2005 – where a person lacks capacity to make a particular decision relating to infection-control measures, visiting or care, decisions must be made in accordance with the Act and in the person’s best interests.
• Human Rights Act 1998 – infection-control arrangements must respect applicable human rights, including the right to respect for private and family life.
• Equality Act 2010 – infection-control arrangements must not unlawfully discriminate and reasonable adjustments must be made where required.

The service will also have regard to current infection prevention and control guidance issued for adult social care in England by the Department of Health and Social Care and the UK Health Security Agency.

4. COVID-19 Prevention Measures

4.1 Infection Prevention and Control Protocols

Standard infection control precautions will be applied at all times. Additional precautions will be introduced following an individual, environmental or outbreak risk assessment where required.

The following measures apply:

• Hand hygiene: Staff must perform effective hand hygiene at appropriate points during care, including before and after contact with a person, between care tasks, following exposure to blood or body fluids, after removing gloves and before clean or aseptic procedures. People we support and visitors will be supported to maintain appropriate hand hygiene.
• Respiratory and cough hygiene: People we support, staff and visitors will be encouraged and supported to follow good respiratory hygiene, including covering coughs and sneezes, disposing of used tissues promptly and cleaning their hands afterwards.
• Ventilation: Rooms and shared areas will be appropriately ventilated, taking account of the person’s comfort, safety and environmental conditions. Fresh air should be introduced regularly where this can be done safely.
• Personal Protective Equipment: PPE will be selected according to the activity being undertaken, the anticipated exposure and the infection risk. PPE will not be used solely because a person lives in a care home or because COVID-19 exists in the community.
• Face masks: Care workers and visitors do not routinely need to wear face masks. Type IIR fluid-repellent surgical masks will be used where recommended by current national guidance, including when caring for a person with symptoms of an acute respiratory infection, when cleaning their room, or where a local outbreak risk assessment identifies universal masking as a proportionate control measure. A person’s reasonable preference for staff or visitors to wear a mask will also be considered.
• Gloves and aprons: Gloves and aprons will be worn where there is a risk of exposure to blood, body fluids or mucous membranes and for other procedures where national infection-control guidance requires them. Gloves must be changed between tasks where required and must not replace hand hygiene.
• Eye protection: Appropriate eye protection will be worn where required by current national guidance, including where staff are working in close proximity to a person with an acute respiratory infection when the identified exposure risk requires it.
• Cleaning: The home will maintain an effective routine cleaning programme. Cleaning frequency will be increased where indicated by the level of infection risk, contamination, individual symptoms or an outbreak. Frequently touched surfaces and shared equipment will receive particular attention. A fixed two-hourly disinfection schedule is not required unless identified as necessary by a specific risk assessment or public-health advice.
• Equipment: Shared care equipment must be appropriately cleaned and, where required, disinfected between people and after contamination.
• Linen and waste: Used or infectious linen and waste will be handled, segregated, stored and disposed of safely in accordance with the home’s infection prevention and control procedures.
• Physical distancing: Routine blanket social distancing will not be imposed. Where reducing close contact forms part of a proportionate response to a specific infection risk or outbreak, it will be introduced only to the extent necessary and will take account of the person’s wellbeing, communication needs, rights and preferences.

All additional infection-control measures must be proportionate to the identified risk and must be reviewed when circumstances change.

4.2 Staff Symptoms, Testing and Return to Work

Routine asymptomatic COVID-19 testing of staff is not required unless this is reintroduced through national guidance or specifically advised by the UKHSA Health Protection Team or another authorised public-health body.

A staff member who develops symptoms of an acute respiratory infection and has a high temperature or does not feel well enough to work must:

• inform their manager promptly;
• stay away from work while they have a high temperature or feel too unwell to work;
• follow current national advice for people with symptoms of a respiratory infection; and
• keep their manager informed of their fitness to return to work.

Staff do not routinely need to take a COVID-19 test because they have respiratory symptoms.

A staff member should test for COVID-19 where:

• they have respiratory symptoms and are eligible for COVID-19 treatments;
• testing has been advised by the UKHSA Health Protection Team;
• testing has been advised by an appropriate clinician; or
• another current national testing requirement applies.

Where a staff member tests positive for COVID-19, they must remain away from work for a minimum of five days from the onset of symptoms, or from the date of the test if they have no symptoms.

After five days, the staff member may return to work when they feel well and no longer have a high temperature. Where respiratory symptoms continue, the manager must undertake a return-to-work risk assessment and seek medical advice where necessary.

A staff member who is merely a contact of a confirmed COVID-19 case does not routinely require COVID-19 testing or exclusion from work solely because of that contact.

Any return-to-work decision must take account of the staff member’s symptoms, the people they support, the nature of their role and any current UKHSA or occupational-health advice.

4.3 Vaccination

{{org_field_name}} recognises vaccination as an important measure for reducing the risk of serious illness from COVID-19 and influenza.

The service will:

• provide people we support and staff with appropriate information about current NHS vaccination programmes;
• support eligible people we support to access vaccination where they wish to do so;
• encourage eligible staff to consider and access vaccination in accordance with current NHS recommendations;
• begin consent arrangements for vaccination of residents in sufficient time where this is necessary to facilitate a seasonal vaccination programme;
• make reasonable arrangements to support informed decision-making, including where a person has communication needs; and
• comply with the Mental Capacity Act 2005 where a person lacks capacity to consent to vaccination.

COVID-19 vaccination is not a blanket condition of employment or residence under this policy.

Any vaccination information held by {{org_field_name}} must have a legitimate purpose, be relevant and necessary for that purpose, be kept confidential and be handled in accordance with applicable data-protection requirements.

5. Managing Suspected or Confirmed Cases of COVID-19

5.1 Identifying and Responding to Symptoms of Acute Respiratory Infection

Staff must remain alert to signs and symptoms of acute respiratory infection, including COVID-19, influenza and respiratory syncytial virus.

Where a person we support develops symptoms of an acute respiratory infection, staff must:

• assess the person’s immediate wellbeing and identify whether urgent medical attention is required;
• inform the person in charge and record the symptoms, observations and actions taken;
• support the person to stay away from other residents where they have a high temperature or do not feel well enough to undertake their usual activities;
• monitor the person’s symptoms and promptly escalate deterioration or clinical concerns to the GP, NHS 111 or emergency services as appropriate;
• ensure appropriate standard and transmission-based infection-control precautions are implemented;
• use appropriate PPE in accordance with current national guidance and the assessed risk;
• increase ventilation where safe and appropriate;
• appropriately clean the person’s room and any shared toilet or shower facilities used by them;
• consider enhanced cleaning of frequently touched surfaces;
• protect the person’s dignity, wellbeing, hydration, nutrition, communication and social contact while they are being supported to stay away from others; and
• continue to facilitate appropriate visiting with proportionate infection-control precautions.

COVID-19 testing will not automatically be arranged for every symptomatic resident.

Where a symptomatic resident is eligible for COVID-19 treatments, they should undertake a lateral flow device test as soon as possible so that treatment can be accessed promptly if the result is positive.

Testing may also be undertaken where specifically advised by a clinician, the UKHSA Health Protection Team or another authorised public-health body.

Where a person who may be eligible for COVID-19 treatment tests positive, the service will arrange or support prompt assessment for treatment in accordance with local NHS arrangements.

Where the resident is not eligible for COVID-19 treatments and testing has not otherwise been advised, they should normally be supported to stay away from others until they no longer have a high temperature and no longer feel unwell.

5.2 Supporting Residents to Stay Away From Others and Cohorting

The term “isolation” will not be used to justify unnecessary restriction of a resident’s rights, movements, social contact or access to essential care. Residents will instead be supported to stay away from others where this is recommended by current public-health guidance and proportionate to the infection risk.

A care home resident who tests positive for COVID-19 should be supported to stay away from other residents for a minimum of five days after the onset of respiratory symptoms.

After five days, the resident may return to their usual activities when they feel well and no longer have a high temperature.

If the resident remains unwell after five days, they should continue to be supported to stay away from others until they feel well and no longer have a high temperature, normally for no longer than ten days in total. Clinical advice must be sought where the resident remains unwell or has a high temperature after ten days, or earlier where there is any clinical concern.

A negative COVID-19 test is not routinely required before the resident resumes their usual activities.

For residents who test positive for influenza or another acute respiratory infection, the service will follow advice provided by the person’s GP, treating clinician or UKHSA Health Protection Team.

Where it is feasible and safe, cohorting of staff or residents may be considered during an outbreak as part of a documented outbreak risk assessment. Cohorting must not be applied automatically and must take account of:

• people’s assessed care and support needs;
• staffing safety;
• the risk of cross-infection;
• residents’ rights, dignity and wellbeing; and
• advice from the UKHSA Health Protection Team where applicable.

Residents being supported to stay away from others must continue to receive appropriate care, activities, emotional support and social contact and must be supported to receive visitors using appropriate infection-control precautions.

5.3 Acute Respiratory Infection Outbreak Management and Notifications

An outbreak of acute respiratory infection should be suspected where two or more residents develop positive or clinically suspected linked cases of acute respiratory infection within the same setting within a five-day period.

Where two or more potentially linked residents develop symptoms within five days of each other, the Registered Manager or delegated competent person must:

• undertake and document an outbreak risk assessment as soon as possible;
• consider whether there is evidence that transmission may have occurred within the care home;
• notify the relevant UKHSA Health Protection Team or other locally designated public-health partner of the suspected outbreak;
• implement proportionate infection-control measures without unnecessary delay where the home is competent to do so;
• follow testing advice provided by the Health Protection Team;
• identify residents who are eligible for COVID-19 treatments and ensure they can access appropriate testing and treatment promptly;
• monitor residents for deterioration and arrange clinical assessment where necessary;
• maintain adequate staffing and seek support from the relevant local authority where staffing shortages or other operational pressures threaten safe care; and
• keep residents, staff and residents’ loved ones appropriately informed about the outbreak and any measures implemented, subject to confidentiality requirements.

The Health Protection Team may recommend multiplex PCR testing of a limited number of linked symptomatic residents. Wider outbreak testing must only be undertaken where advised by the Health Protection Team or other authorised public-health body.

People who are contacts of a confirmed COVID-19 case do not routinely require COVID-19 testing solely because they are contacts.

Outbreak-control measures must be:

• based on the identified risks;
• proportionate;
• time limited;
• the least restrictive measures reasonably available;
• regularly reviewed; and
• balanced against residents’ wellbeing, dignity, rights and care needs.

Measures may include enhanced cleaning, increased ventilation, appropriate use of Type IIR masks, adjustments to communal activities, temporary cohorting of staff, monitoring of residents and other measures advised following risk assessment.

Outbreak-control measures may normally be lifted five days after the onset of symptoms in the most recent symptomatic resident, subject to a local risk assessment and any specific advice from the UKHSA Health Protection Team. Residents should continue to be monitored for a further period where indicated by current national guidance.

The Registered Manager will submit notifications to the Care Quality Commission only where the circumstances meet a statutory CQC notification requirement. A positive COVID-19 result in itself does not automatically require a CQC notification.

Any death, serious injury, event threatening the safe operation of the service or other incident associated with an outbreak must be considered separately against the applicable CQC statutory notification requirements.

6. Visitors and External Professionals

6.1 Visiting and Visits Out

{{org_field_name}} recognises that maintaining contact with relatives, friends and other people who are important to a resident is fundamental to the person’s wellbeing and is protected by Regulation 9A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The starting position is that in-person visiting is permitted and will be facilitated.

Residents must also not be discouraged from taking visits out of the care home unless exceptional circumstances apply.

The service will:

• support residents to receive visits from the people they wish to see;
• take account of each resident’s needs, wishes, preferences and care plan;
• make reasonable adjustments where required;
• use proportionate infection-control precautions to enable visits to proceed safely wherever possible;
• involve the resident and, where appropriate, family members, friends, advocates or other relevant persons when decisions affecting visiting are made;
• record any decision to restrict a visit or a visit out, including the risks considered, the person’s preferences, the alternatives considered and why the restriction is necessary and proportionate; and
• review restrictions promptly and remove them as soon as they are no longer necessary.

Visitors do not routinely need to:

• book visits in advance as an infection-control requirement;
• undergo temperature screening;
• take a COVID-19 test;
• maintain physical distancing; or
• wear a face mask.

Reasonable arrangements for the safe operation of the home may still be agreed with visitors, but these must not amount to an unnecessary barrier to visiting.

Visitors should not normally enter the home when they feel unwell with symptoms of an acute respiratory infection. Visitors will be provided with information about hand hygiene and any infection-control precautions appropriate to the circumstances.

Where a resident has symptoms of an acute respiratory infection, visits should continue to be facilitated with suitable infection-control precautions.

During an infectious-disease outbreak, visiting may only be restricted in exceptional circumstances where a visit would create a significant risk to the health, safety or wellbeing of a person in the home and that risk cannot reasonably be mitigated through other precautions.

Any restriction must be:

• individually considered;
• supported by a risk assessment;
• necessary for a legitimate health or safety purpose;
• proportionate to the identified risk;
• the least restrictive available option;
• time limited; and
• regularly reviewed.

Blanket or indefinite visiting bans must not be imposed.

End-of-life visits must always be facilitated with appropriate infection-control precautions.

Residents must not be prevented from leaving the care home unless there is a separate lawful basis for restricting that person’s movement.

Residents must not routinely be required to isolate, avoid others or undertake an acute respiratory infection test merely because they have returned from a visit outside the care home.

6.2 External Healthcare Professionals, Essential Services and CQC

GPs, community nurses, allied health professionals, therapists and other health and care professionals must be enabled to visit residents where their involvement is required for the person’s care and treatment.

Visiting professionals must follow the infection prevention and control precautions applicable to the circumstances and should follow the same relevant PPE recommendations as other visitors unless their professional role requires additional precautions.

Routine COVID-19 testing must not be imposed as a general condition of entry unless a current national requirement or specific public-health instruction applies.

Emergency services must be given immediate access where required.

CQC inspectors and other persons exercising a lawful statutory power of entry must not be refused access because of an outbreak or infection-control restriction. They must be informed of any known infection risks and supported to follow appropriate infection prevention and control precautions.

7. Staffing, Training, and Well-being

7.1 Training and Staff Competence

All staff whose roles may involve infection prevention and control must receive appropriate induction, training, supervision and competency assessment relevant to their responsibilities.

Training will include, as applicable to the person’s role:

• standard infection control precautions;
• hand hygiene;
• respiratory and cough hygiene;
• recognition of symptoms of acute respiratory infections, including COVID-19 and influenza;
• monitoring residents and recognising signs of clinical deterioration;
• procedures for escalating clinical concerns;
• appropriate selection, putting on, removal and disposal of PPE;
• the circumstances in which face masks, eye protection, gloves and aprons are required;
• environmental cleaning and decontamination;
• safe handling of equipment, linen and waste;
• outbreak identification and escalation procedures;
• the current approach to COVID-19 and other acute respiratory infection testing;
• the rights of residents to receive visitors and take visits out;
• the requirement that infection-control restrictions are proportionate and least restrictive; and
• the staff member’s responsibility to report symptoms or illness that may place people at risk.

Staff competence in infection prevention and control must be monitored and concerns addressed through supervision, additional training or competency assessment as appropriate.

7.2. Staff Well-being and Mental Health Support

• Staff have access to counselling services and mental health support.
• Workloads are monitored to reduce stress and burnout.
• Flexible working options are provided where possible to accommodate personal circumstances.

8. Monitoring, Auditing and Compliance

{{org_field_name}} will maintain effective governance arrangements to assess, monitor and improve infection prevention and control.

The Registered Manager or delegated competent person will ensure that:

• infection prevention and control risks are assessed and reviewed when circumstances change;
• staff remain alert to symptoms of infection and promptly report concerns;
• residents’ health is monitored in accordance with their assessed clinical and care needs;
• routine blanket temperature screening of all residents, staff or visitors is not undertaken unless indicated by an outbreak risk assessment, clinical advice or current public-health guidance;
• infection prevention and control practices are audited at a frequency determined by the risks and needs of the service;
• identified deficiencies result in documented corrective action;
• outbreaks, incidents and infection-control concerns are reviewed to identify learning;
• statutory notifications and public-health reports are made where legally required;
• records relating to infection risks, decisions and outbreak-control measures are accurate, complete and contemporaneous;
• visiting restrictions, where exceptionally required, are documented and regularly reviewed;
• staff training and competency records are maintained;
• feedback from people we support, relatives, visitors and staff is considered when reviewing infection-control arrangements; and
• the service continues to have regard to current national adult social care infection prevention and control guidance.

9. Related Policies

This policy should be read alongside:

• CH11 – Safe Care and Treatment Policy​.
• CH17 – Infection Prevention and Control Policy​.
• CH16 – Health and Safety at Work Policy​.
• CH27 – Staff Supervision, Training, and Development Policy​.
• CH10 – Visiting and Accompanying in Care Homes Policy​.

10. Policy Review

This policy will be reviewed at least annually and sooner where necessary following:

• a change in legislation or CQC regulatory requirements;
• a material change in Department of Health and Social Care or UK Health Security Agency infection prevention and control guidance;
• a significant outbreak or infection-control incident;
• learning from audit, investigation, safeguarding or complaints;
• identified deficiencies in the operation of the policy; or
• changes to the service that materially affect infection risks.

The Registered Manager is responsible for ensuring that material changes are communicated to staff and, where relevant, to people we support, relatives, visitors and other persons affected by the change.

Where national or local public-health guidance changes before this policy is formally reviewed, current statutory requirements and current national public-health guidance will take precedence over any conflicting provision in this policy.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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