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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Significant rise in figures for care home deaths as a result of COVID-19

We have recently written several blogs regarding various COVID-19 related problems the care sector is facing.  In particular the supply of PPE and the effect of COVID-19 generally on staffing levels and management of service users are critical issues.

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Care planning and the use of DNACPR orders in the current crisis

The Chief Executive and Registrar at the Nursing and Midwifery Council (NMC) recently expressed concern that as result of the COVID-19 pandemic, there had been reports of blanket advance care plans, including do not attempt cardiopulmonary resuscitation (DNACPR) orders, being applied to specific groups of people. This is concerning as such decisions have been made without the individual’s involvement or an assessment of their specific needs. These decisions seemed to ignore the requirement that decisions must involve the patient unless to do so would cause harm and if the clinician’s decision is that attempting CPR is futile there is an obligation to tell the patient that this is the decision.

In light of these alarming reports and due to the increasing pressures on healthcare professionals to make urgent and complex clinical decisions, the NMC and the General Medical Council (GMC) issued a joint statement on 15 April 2020 to highlight the continuing importance of advance care planning for individuals during these unprecedented times. At the same time the Department of Health & Social Care (DHSC) also issued guidance on 15 April 2020 confirming that it is unacceptable for advance care plans, including DNACPR to be applied in a blanket fashion. DHSC guidance 15 4 20

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Care Act easements under the Coronavirus Act 2020 and potential issues for private providers

The Coronavirus Act 2020 was brought into force last month and is designed to enable the Government to respond to and manage the effects of the Covid19 pandemic.   Part of the Act allows easements of certain parts of the 2014 Care Act.  But how could this potentially affect private care providers?

The Coronavirus Act 2020 and associated guidance emphasises that easements should only be exercised by Local Authorities where this is essential to provide the highest level of services and that Authorities should comply with their existing Care Act duties for as long as possible.  A Local Authority can only enact Care Act easements when its workforce is significantly depleted, or demand on social care is increased to an extent that the Authority cannot meet its duties under the Care Act.

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Coronavirus: updated guidance for dental professionals on providing urgent dental care

On 15 April 2020, NHS England published updated guidance for dentists which addresses the provision of urgent dental care during the COVID-19 pandemic. The full guidance can be found here.

Further to NHS England’s previous guidance, it is reiterated that the provision of all routine, non-urgent dental care has been suspended until further notice. In providing urgent or emergency dental care, the guidance states that each COVID-19 urgent dental care (UDC) system should deliver the following:

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Government publishes Action Plan for Adult Social Care

Our blog yesterday highlighted the measures outlined by the government relating to the crucial issue of personal protective equipment (PPE) in its Action Plan for Adult Social Care.

The Action Plan outlines various other measures to support the Adult Social Care Sector during the COVID-19 outbreak, which is no doubt welcome news to providers, especially given the recent reports of high death rates and infections in care and nursing homes.

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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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