COVID-19 General Advice

This page last updated: 25/03/2020

Turning Point’s employee wellbeing service, Rightsteps, have developed an online ‘Find Out More’ information guide focusing on supporting health and wellbeing during the Covid-19 pandemic. This is particularly useful for people who suddenly find themselves working from home full time. Click here to find out more and share this link with anyone else who might find it useful

We know that the current COVID-19 crisis is taking its toll on the mental health of all of us, and particularly on frontline health and social care staff. Click here for some information from Anxiety UK. Anxiety UK have extended their helpline hours so they now run 9.30am until 10pm on weekdays and 10am - 8pm at the weekend.

Click here to register if you have a medical condition that makes you extremely vulnerable to coronavirus. For example, you’ll be able to ask for help getting deliveries of essential supplies like food. If you’re not sure whether your medical condition makes you extremely vulnerable, register anyway. You can register yourself, or on behalf of someone else. It’s useful to have your NHS number to hand if you know it. You can find it on any letter the NHS has sent you or on a prescription.

1. Supporting people with COVID- 19

This guide has brought up to date Guidance from Public Health England and Public Health Scotland to describe our approach to supporting people with COVID -19. We will continue to update this as further advice and information is available.


1.1 What are the typical signs and symptoms of COVID-19?
the most common signs of COVID-19 include:
• High temperature or fever
• Cough
• Shortness of breath or breathing difficulties
These symptoms can range from people having a mild-to-moderate illness to severe acute respiratory infection.
However, COVID-19 can cause more severe symptoms in people with weakened immune systems, older people, and those with long-term conditions like diabetes, cancer and chronic lung disease.

1.2 How is COVID-19 spread?
There are two main routes by which COVID-19 can be spread:
• Directly; from close contact with an infected person (within 2 metres) where respiratory secretions can enter the eyes, mouth, nose or airways.
This risk increases the longer someone has close contact with an infected person who has symptoms.
• Indirectly; by touching a surface, object or the hand of an infected person that has been contaminated with respiratory secretions and then touching your own mouth, nose, or eyes.

1.3 How long can the virus survive on surfaces?
Under most circumstances, even without cleaning or disinfection, the amount of infectious virus on any contaminated surfaces is likely to have decreased significantly by 72 hours.
It is known that similar viruses, are often passed by people’s hands and therefore frequent hand hygiene and regular thorough cleaning of frequently touched equipment and surfaces will help to reduce the risk of infection transmission.


2. General Guidance for preventing spread of infection

2.1 What can be done to prevent spread of COVID-19 and other respiratory infections?
There is currently no vaccine to prevent COVID-19. However, there are general principles that we can all follow to help prevent the of this Virus, such as:
• Routine cleaning and disinfection of frequently touched objects and surfaces
(e.g. handrails, tables, the arms of chairs, telephones, keyboards and door handles).
• Promoting good hand hygiene by making sure that everyone, including colleagues the people we support and visitors, have access to hand washing facilities, and wherever possible, and safe to do so, by providing alcohol-based hand rub in prominent places.
• Ensuring any crockery and cutlery in shared kitchen areas is cleaned with warm general-purpose detergent and dried thoroughly before being stored for re-use.
• Avoid leaving food stuffs (e.g. crisps, open sandwiches) exposed and open for communal sharing unless they are individually wrapped.
Individuals should:
• Wash hands often with soap and water; or use alcohol-based hand rub.
• Avoid touching eyes, nose and mouth with unwashed hands.
• Wherever possible, avoid direct contact with people that have a respiratory illness and avoid using their personal items such as their mobile phone.
• Cover coughs and sneezes (nose and mouth) with disposable tissues, then dispose of these in the nearest waste bin after use. And then wash your hands/use alcohol-based hand rub.
Visitors
We recognise that visitors are an important part of people’s lives and restricting access may lead to a sense of isolation and loneliness, however during this time it is advised that only people are encourage to find alternative ways of keeping in contact with family and friends and the number of people who are visiting people’s homes is kept to a minimum.
Where there is known/suspected COVID-19 visitors should be restricted to essential visitors only.
• Local risk assessment and practical management should be considered, ensuring a pragmatic and proportionate response, including the consideration of whether there is a requirement for visitors to wear PPE. These visitors must not visit any other care areas or facilities. A log of all visitors should be kept.
• If required any follow up of contacts of positive individuals will be co-ordinated by the local Health Protection Team.
• If you have concerns about an individual receiving care who may have visitors/ family contact with a someone with confirmed COVID-19, seek advice from the local health protection team.


3 Caring for people with suspected and confirmed COVID-19

3.1 Self- Isolation
The current guidance advises that to reduce the exposure of others to the virus that people with suspected and confirmed COVID-19 need to self-isolate, and to spend as much time alone as possible for up to 14 days
For many of the people we are supporting this may be a difficult time and we need to consider how they can safely be supported as well as what activities we can encourage them to do when self-isolating.
When we are supporting someone, who has suspected or confirmed COVID -19 we need to make sure that we arrange our support in the best/safest way possible, and this guide offers a description of ways of working that are being advised to do this;
When we are caring for someone who has a suspected/confirmed case of COVID-19 we should avoid, where possible, for colleagues providing this support also providing care and support for people who are not self-isolating due to COVID-19. If this can’t be avoided, we should consider caring for the individuals with COVID-19 after those who are not showing any symptoms.

3.2 Self-Caring:
Wherever possible the people who we are supporting should be encouraged to use the skills they have to do as much as possible for themselves and to lead on their care, and if possible, to take the chance to self-care and reduce the dependence on support of their teams
Once someone is suspected or confirmed with COVID-19 it will be difficult to put these sorts of plans into place and It is helpful to consider this in advance of any suspected/confirmed diagnosis, and to consider what elements of someone’s support we could help them to have greater control of now.

4. Where someone with COVID-19 needs support

We know that for many there will continue to be a need to support them with many activities of their daily living and in particular when people are unwell, they will continue to need the support of their teams to help them with many aspects of their lives.

The principles below describe the key things the NHS are advising are needed to keep colleagues safe when providing this support; and It is important that all colleagues working with people who have suspected or confirmed case of COVID- 19 comply with all infection control procedures as set out in this guidance

Where colleagues are pregnant or otherwise immunosuppressed, or have a known health condition that puts them at an additional risk of COVID-19 they should NOT provide direct care for a person with possible or confirmed COVID-19

4.1 The Person’s Room
• People being cared for with suspected and confirmed COVID-19 should be cared for in a single room, and if possible, supported in a room with en-suite facilities.
• Wherever possible It is important that all care for the person should be carried out within their room
• The person’s room door(s) should be kept closed wherever possible, and safe to do so.
o Where this is unsafe, or not possible, we should ensure that wherever possible the person’s bed is moved away from the door to try and achieve a 2 metres distance to the open door.
o This decision needs to be as part of a risk assessment that will be carried out with advice from the local Health Protection Team.
• To reduce the number of people in contact with the person it is important that only those people who need to support the person should enter the room, and only when wearing the agreed personal protective equipment
• While providing care to a person it is important to keep the comings and goings from the persons room to a minimum, particularly if the care includes any supports that are related to respiratory support.
• Advise suggests that if possible, and not too cold, the room should be well ventilated and having a window open to keep fresh air moving through is helpful.

4.2 Personal protective equipment (PPE)
Where we are supporting someone with COVID-19 the guidance advises that we should try and keep 2 metres from them. However, where we are providing personal care this is not possible and colleagues will need appropriate PPE. PPE Should be put on before entering the persons room.
The current recommended minimum personal protective equipment (PPE) required to be worn where a possible or confirmed case has been placed/isolated includes
• disposable gloves
• disposable plastic apron
• fluid resistant surgical face mask.
Where someone is coughing and there is a risk of splashing the use of a full-face visor should be considered and risk assessed.
Where aerosol generating procedures (AGP) such as Continuous Positive Airway Pressure Ventilation (CPAP) are carried out the need for additional PPE such as a Filtering Face Piece (class 3) FFP3 respirator and full-face visor should be worn, in this situation contact the local Health Protection Team who can advise on this.
PPE should be removed once you have left the person’s room and placed in a waste bag.
Hands should be washed after all PPE has been removed. If available decontaminate hands with Alcohol Based Hand Rub (ABHR) following removal of PPE. Where ABHR is not available be careful not to re-enter the care area or within 2 meters of the person receiving care and wash hands with soap and water use disposable paper towels to dry hands and place in domestic waste.
Wherever possible clean hands with ABHR after leaving the property where available.

4.3 Hand Hygiene
This is essential before and after all contact with the person being cared for, removal of protective clothing and cleaning of equipment and the environment.
Wash hands with soap and water . Alcohol-based hand rub can be used if hands are not visibly dirty or soiled. While Alcohol based handrub is useful washing effectively with soap and water is sufficient.

4.4 Keeping the equipment and the rooms people use clean
As part of the support of people there may be equipment that used.
• Where possible use single-use equipment and dispose of as healthcare waste inside the room the person is using.
• Where single use is not possible, it is important that dedicated care equipment is kept to the persons room and should not be shared with other people being supported.
• If dedicated care equipment such as commodes, moving aides are not possible and equipment must be shared, this must be decontaminated following the guidance below
• All dishes, drinking glasses, cups, eating utensils, should be cleaned in a dishwasher, if possible, or hot soapy water, after each use, and dried
As has been highlighted It is possible that these viruses can survive in the environment for some time with virus contamination on hard surfaces decreasing significantly by 72 hours. As such a robust cleaning protocol is important and when cleaning;
• PPE must be worn as already described
• PPE should be put on prior to entering the isolation room.
• To reduce the number of people entering rooms where people are self-isolating, cleaning should ideally be undertaken by staff who are also providing care in the resident rooms.
• The room should be cleaned after the rest of the areas have been cleaned.

4.5 Safe Management of Washing
• Any, towels or other laundry used by the individual should be treated as infectious and placed in an alginate bag then a secondary clear bag before removing from their room and then placed directly into the laundry hamper/bag.
• This should be laundered in line with local policy for infectious linen.
4.6 Disposal of Waste
• All consumable waste items and PPE that have been in contact with the individual, including used tissues, should be put in a plastic rubbish bag, double bagged and tied. These bags should be stored for 72 hours before being put out for collection. They should then be put in a secure location and disposed of in line with other contaminated waste.
• Other household waste can be disposed of as normal
• Waste such as urine or faeces from individuals with possible or confirmed COVID-19 does not require special treatment and can be discharged into the sewage system. If able/possible, the individual should use their en-suite WC. Communal facilities should not be used.


5. Sharing a home with someone with COVID -19

While all attempts should be made to ensure that people are not sharing with people who are suspected/ confirmed as having COVID-19 we realise that this is not always possible.
As such where people continue to share a home with someone with COVID-19 we need to make sure that shared spaces are cleaned in an appropriate manner, there are a number of actions that we need to take to make this happen, including;
• All shared spaces should be cleaned with detergent and disinfectant.
• Detergent/disinfectant should be used to decontaminate all surfaces in the room/area the person has been self-isolating in, including all potentially contaminated high contact areas such as door handles, tables, grab-rails and bathrooms.
• Decontamination of soft furnishings may require to be discussed with the local Health Protection Team.
• If the furnishing is heavily contaminated, you may have to discard it. If it is safe to clean with standard detergent and disinfectant alone then follow appropriate procedure. If it is not safe to clean the item should be discarded.

6. Supporting people who are self-isolating but not symptomatic of COVID-19

People who have been in close contact with a confirmed case of COVID-19 are also being advised by the local Health Protection Team to self-isolate.
It is important to remember that people who are self-isolating and have no symptoms do not pose a risk to others. They are self-isolating to allow closer monitoring in order to identify early symptoms, and to enable prompt medical action if required.
We should remain focused on Good hygiene and continue to use the principles provided about ways to prevent the spread of infection, including the thorough cleaning of surfaces and the regular use of handwashing.
Where an individual is in self-isolation and has not been Symptomatic, colleagues should remain in contact and should ascertain if the individual has started to display symptoms prior to their visit.
For people who are self-isolating If it becomes necessary to defer visits alternative arrangements must be put in place to maintain contact (e.g. telephone).
However, If during a domiciliary visit it is thought that COVID-19 is suspected or confirmed, then colleagues must comply with all infection control procedures as set out in this guidance.

7. Exposure of colleagues to COVID-19, and seeking medical attention

We really appreciate that this is a difficult time for our colleagues, in particular those who are providing direct support to people who have Suspected/confirmed COVID-19.
While the NHS guidance is clear that the use of PPE and good infection control is critical in reducing the likelihood of the spread of infection it is important that we are clear that we want all colleagues continue to consider, and look after their own health and wellbeing, and seek advice and support if they are concerned.
During this time all Colleagues should be vigilant for respiratory symptoms during the incubation period which can be up to 14 days following last exposure to a confirmed case
All colleagues should follow current government and organisational guidance about self-isolation and should not come to work if they have a fever or continuous cough and should during this time avoid contact with people in their family and in the general community.

 

Further resources

Warwickshire County Council
Worcestershire County Council