COVID-19 and Scottish care homes

On 6 May it was announced that five residents had died at a care home on the Scottish island of Skye at the centre of a COVID-19 (C-19) outbreak on the island. 57 residents and staff at this care home have tested positive for C-19. Ten deaths have also recently been reported at a care home in East Dunbartonshire.

Statistics from the National Records of Scotland show that by Sunday 3 May there had been 2,795 deaths in Scotland where C-19 is mentioned on a death certificate. More than four in ten of those deaths (42.8%) have been in care homes. The proportion of deaths in care homes has also been growing, accounting for almost 60% of C-19 deaths between 27 April and 3 May.

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PPE for healthcare workers remains a troubling issue

As reported in our last blog, the Chief Coroner for England and Wales has recently provided updated guidance on inquests, commenting that in the contents of COVID-19, inquests are not a suitable forum to examine high level and government policy relating to the provision of personal protective equipment (PPE).

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Further guidance issued by HM Coroner – COVID-19 deaths

The Chief Coroner for England and Wales issued further guidance on 28 April 2020 in the form of guidance sheet number 37 addressing COVID-19 deaths and possible exposure in the workplace.  This will be of significance to those involved in inquests or investigations relating to COVID-19 deaths.

He confirms that the vast majority of deaths from COVID-19 arise from the natural progression of this naturally occurring disease and therefore will not be referred to the coroner. He reminds his coroners of the Ministry of Justice guidance on the Notification of Deaths Regulations 2019 which confirms that a death is to be typically considered unnatural if it has not resulted entirely from a naturally occurring disease process, importantly it goes on, where nothing else is implicated.

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Care providers: COVID-19 and PPE

The previous guidance from the Department of Health and Social Care failed to address adequately the issue of personal protective equipment (PPE) in care homes. With this said, on 15 April 2020 the Department of Health and Social Care published a new action plan for Adult Social Care, which aims to address the concerns, specifically in respect of PPE. This applies to both care homes and generally any setting where people receive adult social care.

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Coronavirus (COVID-19): Official Guidance for admission and care of people in care homes

Background

The Department of Health and Social Care has provided guidance for care homes, local health protection teams, local authorities, clinical commissioning groups (CCGs) and registered providers of accommodation for people who need personal or nursing care during the coronavirus (COVID-19) outbreak. The guidance sets out how to admit and care for residents safely and protect care home staff.[1]

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Covid-19 highlights issues surrounding delegation of nursing care tasks to home care workers

Within the social care sector, certain tasks are generally seen as tasks that can only be undertaken by nurses.  Examples of this might include administering injections or administration of mediation via feeding tubes.  Prior to the current Covid-19 crisis, the CQC’s guidance (based on NICE guidelines in 2017) stated that in certain circumstances nursing tasks could be delegated to care home staff.  This would be subject to the nursing staff/healthcare professionals being satisfied the care worker was satisfactorily trained and competent to undertake the task.  The healthcare professional would remain responsible for ensuring that the care worker was undertaking the task correctly.  The CQC’s previous guidance stated that care home providers should have policies in place to cover this possibility and that the care workers should be properly trained in the task they were being asked to undertake.

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The Coronavirus Act 2020 – implications for health and care practitioners, a round up

The Coronavirus Act 2020 (the Act) received royal assent on 25 March 2020, allowing the provisions initially for a period of two years, with the powers to be lengthened or shortened, and will be reviewed every six months.  Not all measures will come into force immediately as the Government has the power to switch these new provisions on and off when necessary. An overview of some of the provisions affecting health care professionals is outlined below.

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