The government has confirmed that social workers and care workers, along with other frontline medical staff, are key workers, whose work is critical to the national COVID-19 response. In their new guidance for care home providers, published last Thursday (2 April 2020), the government confirmed their commitment to support care home providers in protecting both staff and residents, acknowledging that care staff play a vital role in looking after the most vulnerable in society during this pandemic.
This article covers some of the key staffing issues facing care home providers at the moment, from managing individual staff illness, to meeting the new demand for care provision in a way that ensures residents' needs are met in compliance with regulations.
Guidance on dealing with individual members of staff
The guidance emphasises that key staff must act in line with Public Health England's (PHE) directions on social isolation. If staff develop symptoms of COVID-19, they should not attend work, they should notify their line manager as soon as possible, and then self-isolate for 7 days in accordance with government guidance.
Care home staff who have a symptomatic household member must stay at home and not leave the house for 14 days from the day when the first person in the house becomes ill. If the staff member develops symptoms during this period, they can return to work 7 days after their symptoms started and they are no longer symptomatic.
Clinically vulnerable staff should not provide direct care to symptomatic residents, and care providers must ensure that steps are taken in this regard to properly mange the enhanced risk to that employee's health and safety. Care providers should also consider whether some staff (for example admin staff) can work from home during the COVID-19 pandemic.
Managing staffing shortages
All care homes should have a business continuity policy in place and should consider how they will make up for staff shortages which are likely to arise during the COVID-19 pandemic, as a result of existing members of staff needing to self-isolate, or in response to admitting an increased number of residents.
The CQC have advised that providers work collaboratively with others, which may include the pooling staff with other providers, in order to respond to shortages. It remains key, however, that staff are fit and proper persons, safe to deploy, and competent to support the people who use your service. Working with local authorities to facilitate the sharing of workforces between providers has also been advised by PHE.
The CQC have confirmed that providers are able to recruit volunteers (including family members) during this period, but that they must be appropriately background checked, trained, supervised and supported.
Last week's guidance confirms that the government intends to work with commissioners to ensure prompt payment not only for existing care commitments, but for additional care provided, in recognition of the fact that staffing costs may be higher than usual.
Relaxation on rules for new starters
In recognition of the need for newly recruited staff to start urgently in order to meet the increased demand for carers, a temporary new DBS service has been introduced for certain healthcare roles including nurses and social workers, allowing for a Fast-track Barred List Check result within 24 hours, with the full DBS check to follow.
The CQC have said that whilst providers should exercise diligence around all aspects of safe recruitment, they understand that, "during this time, providers may have to assess their situation and consider starting a new member of staff or volunteer based on less evidence than they normally would." If providers take reasonable steps to ensure staff are recruited in line with the new DBS guidance, staff are adequately supported and sufficiently supervised so that people are safe, the CQC say they do not intend to take a punitive approach. Further guidance on recruitment checks is available on the CQC's website.
Further, providers may need to be more flexible in relation to providing inductions and training to staff, including adapting usual practices and offering some elements of induction training online.
Risk to ongoing care provision
If there will be significant staff shortages that affect the care home's ability to meet peoples' assessed needs safety, the CQC should be notified without delay. In addition, the government advises that where providers consider there to be imminent risks to the continuity of care, such as the potential closure of a service, this should be raised with the local authority immediately.
Conclusion
Whilst the CQC have stopped routine inspections from 16 March 2020, they will still exercise their inspection powers in cases where they have concerns of harm, and providers remain under duties to notify the CQC about certain changes, events and incidents that affect their service, including those brought about by COVID-19.
Care providers will no doubt be concerned about the health, safety and welfare of their staff and residents, and how best to protect them in these unprecedented times. We will be publishing further articles in relation to PPE, infection control and isolation measures in due course. If you would like further information with regards to these issues, or require input from our specialist regulatory healthcare team, please do not hesitate to get in touch with Vikki Woodfine and Kate Kay.
