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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 the arrangements operated by {{org_field_name}} for preventing, identifying and managing COVID-19 as an acute respiratory infection within the care home.

COVID-19 is managed within the wider framework for acute respiratory infections, which includes COVID-19, influenza and respiratory syncytial virus (RSV). {{org_field_name}} will therefore apply infection prevention and control measures proportionately and in accordance with the current Welsh Government social care guidance, Public Health Wales guidance and the National Infection Prevention and Control Manual applicable in Wales.

This policy supports compliance with the Regulation and Inspection of Social Care (Wales) Act 2016 and the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, including the requirements relating to hygiene and infection control.

The service will maintain satisfactory standards of hygiene, take appropriate measures to minimise the transmission of infection and ensure that infection prevention and control measures are balanced with residents’ dignity, rights, independence, personal outcomes, relationships and overall well-being.

2. Scope

This policy applies to all staff, residents, visitors, volunteers, contractors and health and social care professionals entering or working within {{org_field_name}}.

It covers:

• standard infection prevention and control precautions;
• transmission-based precautions where these are indicated;
• recognition and management of symptoms of acute respiratory infection;
• arrangements for symptomatic residents and staff;
• testing where testing is clinically or public-health indicated;
• appropriate use of personal protective equipment;
• environmental cleaning, decontamination, waste and laundry management;
• ventilation;
• vaccination;
• visiting arrangements;
• management of respiratory infection incidents and outbreaks;
• communication with residents and representatives;
• statutory recording and notification requirements; and
• staff training, competence, monitoring and review.

COVID-19-specific measures will not be applied routinely where they are no longer required by current Welsh Government or Public Health Wales guidance. Measures will be proportionate to the assessed risk and will be reviewed whenever relevant national or local public-health guidance changes.

3. Related Policies

This policy should be read alongside the following:

• CHW17 – Infection Prevention and Control Policy: Guidelines on hygiene, PPE usage, and sanitation practices.
• CHW18 – Risk Management and Assessment Policy: Identifying and mitigating risks associated with COVID-19.
• CHW23 – Lone Working and Staff Safety Policy: Ensuring staff safety in isolation scenarios.
• CHW33 – Staff Leave and Absence Policy: Managing COVID-19-related sick leave and self-isolation.
• CHW36 – Communication and Engagement with Service Users and Families Policy: Maintaining transparent communication during outbreaks.
• CHW25 – Notification of Other Incidents Policy: Ensuring regulatory compliance in reporting outbreaks.

4. Policy Statement

{{org_field_name}} is committed to providing care and support in a manner which protects, promotes and maintains the safety and well-being of residents while respecting that the care home is each resident’s home.

The service will maintain effective arrangements for hygiene and infection prevention and control in accordance with Regulation 56 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Infection prevention and control policies, procedures and working practices will be aligned with current Welsh Government and Public Health Wales guidance and the National Infection Prevention and Control Manual applicable in Wales. Standard Infection Control Precautions will be applied routinely, with additional Transmission Based Precautions introduced following assessment of the infection risk.

Any additional restrictions introduced because of COVID-19 or another acute respiratory infection will be necessary, proportionate to the identified risk and maintained for no longer than required. Decisions will take account of the resident’s physical health, mental and emotional well-being, dignity, autonomy, relationships, communication needs and personal outcomes.

The Responsible Individual and Registered Manager will ensure that this policy is kept under review and amended where changes to legislation, statutory guidance, public-health guidance or national infection prevention and control requirements make this necessary.

5. Prevention and Management of Acute Respiratory Infection, Including COVID-19

{{org_field_name}} will apply Standard Infection Control Precautions routinely and additional Transmission Based Precautions where indicated by the assessed risk, symptoms, suspected or confirmed infection, or advice from the relevant health protection professionals.

The following arrangements apply:

• Hand hygiene: Staff must undertake effective hand hygiene at the appropriate times and in accordance with current infection prevention and control guidance. Residents and visitors will be supported and encouraged to maintain good hand hygiene. Suitable handwashing and hand-decontamination facilities will be readily available.
• Respiratory and cough hygiene: Residents, staff and visitors will be encouraged and supported to follow appropriate respiratory and cough hygiene measures, including the safe disposal of used tissues and hand hygiene following contact with respiratory secretions.
• Personal Protective Equipment: PPE will be selected and used according to the activity being undertaken, the anticipated exposure and the assessed risk. PPE will be used in accordance with the National Infection Prevention and Control Manual and current Public Health Wales or Welsh Government guidance. PPE will not be used as a substitute for hand hygiene or other required infection prevention and control measures.
• Cleaning and decontamination: The care environment, frequently touched surfaces, reusable equipment and residents’ rooms will be cleaned and decontaminated using appropriate products and methods in accordance with current infection prevention and control guidance and manufacturers’ instructions. Cleaning arrangements will be increased where the assessed infection risk requires this.
• Waste and laundry: General waste, clinical waste and contaminated laundry will be handled, stored and disposed of safely in accordance with the service’s infection prevention and control procedures and applicable health and safety requirements.
• Ventilation: Indoor areas will be appropriately ventilated where this can be achieved safely and without compromising residents’ comfort, safety or well-being. Ventilation arrangements will form part of the service’s assessment of respiratory infection risk.
• Monitoring for symptoms: Staff must remain alert to signs and symptoms of acute respiratory infection in residents and take appropriate action where symptoms develop. This includes clinical observation, seeking healthcare advice where required and implementing appropriate infection prevention and control measures.
• Testing: Routine asymptomatic COVID-19 testing of residents or staff will not be undertaken unless this is subsequently required by national or local public-health guidance. Testing will be undertaken where clinically indicated, where required to determine eligibility for treatment, or where advised as part of the investigation or management of an incident or outbreak.
• Visitors: Routine COVID-19 testing or temperature screening will not be a condition of visiting unless specifically required by current public-health advice. Visitors who are unwell or have symptoms of an infection will be advised not to visit until it is appropriate for them to do so.

The Registered Manager will ensure that current national guidance is consulted when respiratory infection is suspected or confirmed and that additional precautions are introduced or withdrawn according to the level of risk.

6. Staff Responsibilities and Workplace Safety

All staff have a responsibility to follow the service’s infection prevention and control policies, training and current guidance.

Staff must:

• follow Standard Infection Control Precautions and any additional Transmission Based Precautions relevant to their duties;
• maintain effective hand and respiratory hygiene;
• use PPE correctly where required following assessment of risk;
• report symptoms of acute respiratory infection or a high temperature to their manager as soon as possible;
• not attend work when they have symptoms of a respiratory infection and are unwell or have a high temperature where their work involves close contact with people receiving care;
• follow current Welsh Government, Public Health Wales and occupational-health advice regarding return to work;
• discuss with their manager any additional precautions which may be necessary if someone in their household has symptoms of a respiratory infection or has tested positive for COVID-19;
• participate in testing where this is specifically indicated by current public-health, clinical or occupational-health advice;
• report suspected or confirmed infection in a resident promptly and follow the service’s escalation arrangements;
• complete required infection prevention and control training and competency assessments; and
• follow any additional measures introduced during an incident or outbreak.

Staff who are household or other close contacts of a person with COVID-19 will not automatically be required to self-isolate solely because they are a contact. The Registered Manager will consider the circumstances and apply current Welsh Government, Public Health Wales and occupational-health advice.

Staff will be encouraged and supported to receive vaccinations for which they are eligible under current national vaccination programmes.

7. Resident Protection and Support

Where a resident develops symptoms of an acute respiratory infection, including suspected COVID-19, staff will undertake an immediate assessment and implement appropriate infection prevention and control measures.

The following arrangements will apply:

• The resident’s symptoms, general condition and any clinical deterioration will be monitored, documented and escalated to an appropriate healthcare professional where necessary.
• A symptomatic resident should be supported to remain in their own room, or otherwise separated from individuals at increased risk, where this is appropriate and can be achieved safely until their symptoms have resolved or current guidance indicates that additional precautions are no longer required.
• Where COVID-19 or another acute respiratory infection is confirmed, the service will follow the current infection-specific advice issued by Public Health Wales or the relevant health protection professionals regarding the period for which additional precautions are required.
• Residents with the same suspected or confirmed respiratory infection may be cohorted where this is advised and can be achieved safely.
• Any decision to isolate or cohort a resident will take account of the resident’s capacity, wishes, communication needs, mental and emotional well-being and the potential harm that may result from restrictions.
• Restrictions will be proportionate and maintained for no longer than necessary.
• Residents will continue to receive appropriate care, meaningful social contact, activities, access to communication and support to maintain relationships during periods when additional infection-control precautions are necessary.
• Residents will not routinely be required to wear face masks. Where a symptomatic resident is able to tolerate a face mask, they may be supported to wear one when other people are in their room where this is advised by current infection prevention and control guidance.
• Healthcare advice will be sought promptly where a resident may be eligible for antiviral or other treatment.
• Residents will be supported to access vaccinations for which they are eligible under the current national vaccination programme.

Any significant change in a resident’s health, care or support needs will be reflected in their records and, where necessary, their personal plan and relevant risk assessments.

8. Outbreak Management and Response Plan

For the purposes of this policy, a respiratory infection incident or outbreak will be identified and managed in accordance with current Welsh Government and Public Health Wales guidance.

Where two or more residents or staff develop acute respiratory symptoms and there is concern about linked cases or ongoing transmission within the service, the Registered Manager must seek advice from the appropriate local health board or Health Protection Team and implement the measures advised.

An outbreak may be declared where two or more resident or staff cases of respiratory infection occur within the setting and there is suspicion of transmission associated with the care setting or evidence of ongoing transmission.

Where an incident or outbreak is suspected or confirmed, {{org_field_name}} will:

• undertake and document an immediate infection prevention and control risk assessment;
• contact the relevant local health board or Health Protection Team and follow the advice provided;
• identify symptomatic residents and staff and implement appropriate infection prevention and control measures;
• isolate or cohort symptomatic or affected residents where appropriate and safe to do so;
• implement Standard Infection Control Precautions and any additional Transmission Based Precautions required;
• review PPE requirements and ensure staff and visitors have access to appropriate PPE;
• increase environmental cleaning and decontamination where indicated;
• review staffing arrangements and take reasonable measures to minimise avoidable transmission between affected and unaffected areas;
• arrange testing only where clinically indicated or where advised by the relevant health protection professionals as part of incident or outbreak management;
• facilitate access to clinical assessment and antiviral or other treatment where residents are eligible;
• maintain appropriate ventilation;
• continue to support residents’ dignity, well-being, communication, activities and relationships;
• keep residents and, where appropriate, their representatives informed about the outbreak and any measures which directly affect them;
• review visiting arrangements using an individual and service-level risk assessment rather than automatically stopping visiting;
• keep accurate records of the outbreak, decisions taken, advice received, control measures implemented and subsequent actions;
• notify Care Inspectorate Wales of the outbreak of infectious disease in accordance with Regulation 60 and Schedule 3 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, using CIW Online;
• make any other notifications required by legislation or directed by the relevant health protection authority; and
• ensure that the Responsible Individual is informed without delay of any significant outbreak of infection or any event affecting the safe provision of the service.

Whole-home COVID-19 testing, routine contact tracing or automatic quarantine of asymptomatic contacts will not be initiated solely because an outbreak has occurred unless specifically advised under current national or local public-health arrangements.

The outbreak will be considered over in accordance with the current Welsh Government and Public Health Wales criteria. For acute respiratory infection outbreaks, current national guidance will be checked at the time of the incident before restrictions or additional precautions are withdrawn.

9. Visitors and Family Engagement

{{org_field_name}} recognises that maintaining relationships with family members, friends and other people who are important to residents is an essential part of residents’ well-being.

Visiting arrangements will therefore remain as open and flexible as possible, including during incidents and outbreaks, subject to proportionate infection prevention and control risk assessment.

The following arrangements apply:

• Visitors will not routinely be required to undertake COVID-19 testing or temperature screening before entering the care home.
• Visitors who have symptoms of a respiratory infection or another potentially infectious illness, have a high temperature or feel too unwell to undertake their normal activities will be asked not to visit until it is appropriate for them to do so.
• Visitors will be encouraged to undertake appropriate hand and respiratory hygiene.
• PPE will be offered or required where indicated by the activity being undertaken, the resident’s condition, an outbreak risk assessment or current infection prevention and control guidance.
• Face masks will not routinely be required when there is no infection-related reason for their use.
• Where a respiratory infection outbreak has been identified, visiting will not automatically be stopped.
• Any temporary restriction to visiting will only be introduced following a documented risk assessment and where it is necessary and proportionate to the identified infection risk.
• Essential visiting will continue during an outbreak in accordance with current Welsh Government guidance. Residents may nominate essential visitors in accordance with the arrangements specified in current national guidance.
• Residents receiving end-of-life care will be supported to receive visits from people who are important to them, with appropriate infection prevention and control measures applied.
• Residents will be supported to communicate with family and friends using telephone or digital communication where they choose to do so, but virtual contact will not routinely be used as a substitute for face-to-face visiting.

The Registered Manager will review visiting arrangements whenever the infection risk changes and will remove additional restrictions as soon as they are no longer necessary.

10. Respiratory Vaccination

Vaccination is an important measure for reducing the risk of severe illness from COVID-19 and other vaccine-preventable respiratory infections.

{{org_field_name}} will:

• support residents to access COVID-19, influenza, RSV or other respiratory vaccinations for which they are eligible under the current national vaccination programme;
• encourage eligible staff to take up vaccinations offered to them;
• provide residents and staff with access to reliable and current vaccination information to support informed decision-making;
• respect a person’s right to make an informed decision regarding vaccination, subject to the legal framework for consent and mental capacity;
• work with primary care, vaccination teams and other relevant health professionals to facilitate vaccination programmes within the care home where appropriate; and
• record vaccination information relating to a resident where it is relevant to their healthcare and care records.

Information about the vaccination status of staff will only be collected, used, retained or shared where there is an identified lawful and necessary purpose, in accordance with applicable data protection and employment requirements.

Vaccination will not be treated as a substitute for required infection prevention and control precautions.

11. Training and Competency

All staff receive mandatory training on:

• COVID-19 symptoms, transmission, and prevention strategies.
• Proper use of PPE and hand hygiene protocols.
• How to manage a COVID-19 outbreak within the care home.
• Mental health support for residents affected by isolation.

12. Compliance and Monitoring

{{org_field_name}} will maintain systems for monitoring compliance with this policy and the infection prevention and control requirements applicable to the service.

Monitoring arrangements will include:

• regular review of infection prevention and control practice;
• audits of hand hygiene, PPE practice, environmental cleanliness and other relevant infection prevention and control measures;
• monitoring whether staff have completed required infection prevention and control training and demonstrated appropriate competence;
• review of infection incidents, suspected transmission and outbreaks;
• confirmation that outbreaks of infectious disease are appropriately recorded;
• confirmation that notifications required under Regulation 60 and Schedule 3 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended, have been submitted to Care Inspectorate Wales;
• review of advice or recommendations issued by Public Health Wales, the local health board, Health Protection Team, Care Inspectorate Wales or other relevant authorities;
• investigation and action where infection prevention and control procedures have not been followed;
• identification of themes, trends and lessons arising from infection incidents and outbreaks; and
• implementation and monitoring of improvement actions where deficiencies are identified.

The Responsible Individual will ensure that effective systems are in place for recording incidents and matters requiring regulatory notification and for ensuring that required records are accurate, complete and maintained securely.

The Responsible Individual will also ensure that suitable arrangements are in place for this policy and associated infection prevention and control procedures to be kept up to date.

Significant outbreaks of infection, concerns about infection prevention and control or circumstances which affect the service’s ability to continue providing care safely must be escalated to the Responsible Individual and service provider without delay.

Evidence from infection prevention and control audits, incidents, outbreaks, notifications and improvement actions will contribute to the service’s quality assurance and quality-of-care review arrangements.

13. Policy Review

This policy will be reviewed quarterly or sooner if new guidance is issued by CIW, Public Health Wales, or the Welsh Government. Any updates will be communicated to all staff and stakeholders.

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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}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.