Adapting for the longer term

Adapting for the longer term at Peverel court care

We provide a wonderfully positive setting for your precious loved ones. Our elderly guests will experience a sense of wellbeing with calming reassurance, happy social interactions, creative activities, wholesome nutrition with plenty of fresh air and sunshine in the flourishing nature of our beautiful gardens and woodlands.

The safety and well-being of our residents is our utmost priority and this is has been brought into sharp focus with the recent pandemic. We believe that a family’s ability to visit their loved ones in care homes is of fundamental importance to maintaining that well-being. As such it is imperative that our Homes provide the right setting for this to take place and for residents to live their lives as they have known, now and in the future.

We have drawn on our wealth of experience, research and capabilities to ensure we offer a safe and pleasurable environment for all our residents and the changes we have made can remain for as long as they are needed.

Here are some of the key features to this provision:

– We use rigorous thrice weekly testing, conducted by newly appointed designated ‘testing coordinator’s, to ensure our staff are free of the virus and in turn prevent any spread of the virus.

– All residents and staff are offered a vaccine and we make every effort to ensure that every staff member has the vaccine before entering our employment. Very shortly, it may well be that vaccination is a national prerequisite to taking up employment in healthcare settings such as ours.

– We have infrared temperature monitors at all main entrances for staff and any visitors permitted into the Home.

– All contractors, visitors and visiting practitioners are tested with rapid lateral flow tests prior to entering the buildings.

– All bedrooms and communal areas are routinely disinfected using BioChem misting equipment.

– We have designated staff and equipment to facilitate visits within safe parameters and the mandate of any government guidance. All residents have dynamic risk assessments in place to mitigate risk of social isolation where visiting restrictions are unavoidable.

– Our Homes all utilise state of the art air purifiers to facilitate safer visiting.

– Significant investment in additional full time personnel to ensure we limit movement between healthcare settings, remain fully staffed and continue to provide safe and effective care. This includes additional maintenance, administration and housekeeping personnel to maintain our rigorous deep cleaning schedules, including deep cleaning of furniture, curtains, bedrooms and two hourly cleaning of transmission points, such as door handles, keypads and handrails. A robust recruitment and retention scheme ensures our success in this area.

– Well-established and successful supply chains, ensuring continuity of supply of all required Personal Protective Equipment.

– All staff receive advanced infection control training.

– Families can view our Homes remotely by virtual tour and video conference calls can be arranged with families if multiple parties wish to discuss residency with Home Managers. Where not desired or possible, face to face viewings can still be arranged with additional safety precautions taken.

– The Homes have invested significantly in digital infrastructure to ensure families can stay in touch regardless of circumstances. Superfast fibre broadband available for all residents and a dedicated guest network throughout. iPad tablets, FaceTime, Zoom and Skype access enable regular communication between residents and their relatives.

– We are progressing toward non-touch photo sensor lighting in all appropriate areas.

Visiting Policy During Covid-19

Introduction:

Receiving visitors is an important part of care home life. Maintaining opportunities for visiting to take place is critical for supporting the health and wellbeing of residents and their relationships with friends and family.

Our first priority is ensuring that residents continue to receive the care and support they need. That includes making sure that residents are not put at avoidable risk of contracting COVID-19, which can have such a devastating impact if it spreads through the Home, infecting vulnerable residents and staff members.

Our aim is to continue to work to find the right balance between the benefits of visiting on wellbeing and quality of life, and the risk of transmission of COVID-19 to care staff and vulnerable residents as we enter national restrictions.

Current Approach:

This policy sets out measures that Peverel Court Care (PCC) have put in place, in line current government guidance, to provide COVID-secure opportunities for families to meet using infection prevention control measures such as temperature screening, limited access to the Home, substantial screens, designated visiting areas, air purifiers, disinfection systems, use of PPE, risk assessments etc prior to visits.

PCC will continue to review it’s overall approach to visiting arrangements in line with government guidance.

Each care home is unique in its physical environment and facilities.  Residents vary in their needs, health and current wellbeing.  The individual resident, their views, their needs and wellbeing are an important focus of decisions around visiting.  These decisions will be reached following individual risk assessments, as well as working with relatives and where applicable other relevant professionals.  As such, care home managers are best placed to develop their own policies (in consultation with residents and their relatives) to ensure that the visits described in this guidance are provided in the best way for individual residents, their loved ones, and care home staff.   It is strongly recommended that all visitors and residents take the opportunity to be vaccinated before conducting visits.

PCC recognises the importance of visiting as residents approach the end of their lives. As has been the case throughout the pandemic, response visits in exceptional circumstances such as end of life will continue.

Visiting Schedules:

Under the present circumstances, visits to the Homes are still being controlled, this is based on a dynamic risk assessment, the layout of the home, numbers of residents and families etc.  This is likely to mean that the frequency of visits is limited by setting specific constraints.  We ask that visitors be patient and understanding, as the Home will need to ‘share out’ visiting appointments so that all the residents have the opportunity to have one.

It is a requirement that all visits will have to be pre-booked and with limited availability.  The Home will base its priorities on the following:

  • the importance to the wellbeing of the individual to have a resumption or continuation of visits
  • the degree of harm that might occur without any visits
  • the risk factors that are involved including the vulnerability to infection for the person concerned
  • the degree of compassion that is involved, e.g. if the person is receiving end of life care or is likely to be receiving it in the near future
  • the importance of visiting to the person in the context of their overall care plans
  • the effectiveness of the current contact or visiting arrangements in place
  • allocation of staff to support throughout the visit
  • allocation of staff to allow for effective deep cleaning before and after visits to reduce the risk of transmission

Care home managers will exercise their judgement when developing practical arrangements to put national guidance into practice so that visiting can take place smoothly and comfortably.

Each resident will have a visiting risk assessment, which will set out the arrangements for that individual together with an agreement outlining people’s responsibilities for the safe and successful conduct of the arranged visits.

All visitors will be asked to supply their contact details in addition to the usual signing of the visitors’ book/E-reception, which is required on other grounds, in line with the Government’s test and trace guidance. This information will be held for 21 days before being destroyed in line with data protection laws.

Visitors

Every care home resident can have ‘named visitors’ who will be able to enter the care home for regular visits.  Although the number limit on named visitors is now lifted, residents should still identify their named visitors to the care home so they can be supported for the necessary testing and support required to facilitate COVID-secure visits. These should remain unchanged, within reason.

Any visits involving children should be carefully considered by the family. The arrangements for the visit; in particular the numbers involved, need for testing, and where the visit will take place must be planned and agreed with the care home in advance of the visit.  Where reasonable and practicable (depending on the age of the child) any children visiting should wear the same PPE as adult visitors.

Visits for additional family or friends can take place outdoors, including at a window with a screen between the visitor and the resident.  These type of visits will still need to be booked and arranged with the care home.

Entry points:

Under the present circumstances, all our Homes have limited access into the buildings in order to reduce the risk of transmission.  There is a designated entrance for visitors for infection prevention control purposes in each Home.  When scheduling a visit to the Home, the Home will advise on which entry point should be used to access the building.  Visitors will still need to either call the Home or use the door bell to alert staff of their presence so that a member of staff can escort them through the checking in process.

  • A negative Covid-19 test is required prior to every visit. All visitors will be required to take a rapid lateral flow test at the Home on the day of every visit.
  • Temperature checks will be carried out using a thermoscan upon entry
  • Hand washing or hand sanitiser must be completed upon entry into the Home
  • A face mask (provided by the Home) must be worn upon entry into the Home
  • Additional PPE such as gloves and apron may be required depending on the nature of the visit. Staff will be able to inform you if this is required.

Visitors’ Risk Assessments:

When visiting our Home you will be asked some health screening questions at the start of your visit:

  • check before entering the building that you are not feeling unwell and not exhibiting any Covid-19 symptoms
  • check you have not tested positive for Covid-19 in the past 10 days; and you have not had any contact with anyone who recently tested positive or is exhibiting any Covid-19 symptoms
  • check that you have not recently travelled to countries not on the safe travel list
  • sign a short disclaimer to this effect

You will also be advised of the following:

be extra careful about being in physical contact with the person you are visiting and other people whom you might meet by:

  • Named visitors and residents are advised to keep physical contact to a minimum. Physical contact like handholding is acceptable if hand washing protocols are followed. Close personal contact such as hugging presents higher risks but will be safer if it is between people who are double vaccinated, without face-to-face contact, and there is brief contact only.
  • Visitors should also limit contact with staff, and maintain as much distance as possible. Where needed, conversations with staff can be arranged over the phone following an in-person visit.
    • avoiding close contact with people, and observe social distancing at all times.
    • keeping to designated areas of the building which we will inform you about
  • carry out stringent hand hygiene practice by always washing or sanitising your hands carefully before and after entering the building — using the soap and hand sanitiser gels and paper towels provided
  • using tissues provided should you sneeze and discard them in a bin
  • wear a face mask (provided by the Home) at all times
  • help staff to carry out the procedures that have been put in place to keep everyone safe from the virus and its spread
  • report and discuss with us any concerns you have about the health of the person whose welfare is your concern.

We are confident that with these precautions in place we will be able to keep our residents safe.

Face Masks:

COVID-19 spreads through the air by droplets and aerosols that are exhaled from the nose and mouth of an infected person. Though face coverings are no longer required by law in any setting, they reduce the risk of spreading COVID-19, especially when there is close contact between people in enclosed and crowded spaces.  Therefore, all staff and visitors to the Home will be required to wear face coverings, provided by the Home.

However, the Home in consultation with its public health partners will always exercise discretion in instances where on the one hand residents are frightened or affected adversely by having to or seeing their visitors in face coverings and on the other hand, visitors have reasonable grounds for not wearing them, which can be discussed at pre-visiting planning.

*Where residents might be frightened by the use of face masks, clear face masks or clear visors should be attempted in the first instance.  If this is not possible a separate risk assessment should be carried out for that individual resident.   Under no circumstances should this assessment be applied for a whole care setting.

Where it has been agreed that face masks should not be worn, all parties will be reminded of the importance of maintaining physical distancing and hand hygiene procedures.

Location of visits:

  • Weather permitting, we would encourage that visits take place in a designated location outside. However, if the weather does not allow for visits to take place outside, visiting arrangements will take place in a designated indoor area for named visitors only.  The Home will ensure that the designated indoor area can be accessed and used safely without risk to and from the other parts of the home.

If the weather does not permit outside visits, non-designated visitors will be supported to visit through a window with a substantial screen between the resident and visitor – designed to reduce the risk of viral transmission.

Whilst these areas will be well ventilated with windows opened, air purifiers will also be in use where possible.

Where a resident has particular needs (for example, those who are unable to leave their rooms), the Home will carry out a risk assessment in order to develop an individualised visiting arrangement for that resident.

For such visits:

  • A maximum of 2 visitors at any one time
  • Visitors per resident will be restricted to named visitors each time. This is in order to limit the overall number of visitors to the Home and/or to the individual, and the consequent risk of disease transmission from multiple different routes
  • Infection control measures to be followed including cleaning, supervision, provision of PPE, carrying out of risk assessments
  • Visitor access to the Home will be restricted to designated room only

Visits out of the care home:

Please note the following as per current national guidance updated on 19.07.21:

  • Spending time with others outside the care home will increase the risk of exposure to COVID-19 for the resident and potentially to other residents and staff on their return. This is the case even as we see vaccine coverage increasing.
  • It is strongly recommended that all visitors and residents take the opportunity to be vaccinated before conducting visits.
  • Our individual Homes will consider both the benefits and potential risks involved in a visit out of the care home, in order to recommend measures to mitigate risks before, during and after the visit. Consideration will be given to the risk to other residents (who may be particularly vulnerable) and staff.
  • Where certain types of activity are considered to have an inherently higher risk, the advice is that in these cases the resident should self-isolate on their return (to the care home). This is to ensure that, in the event they have unknowingly become infected while out of the home, they minimise the chances of passing that infection on to other residents and staff.

These activities are:

  • overnight stays in hospital
  • visits assessed to be high-risk following an individual risk assessment by the Home

The resident and where appropriate their family will be involved in discussions throughout the risk assessment process. If undertaking a visit out is not possible without self-isolation on return because of the risk to the individual and other residents and staff, the Home will communicate the reasons for this decision clearly to the resident and where appropriate their family.

  • Individual risk assessments for visits out will take into account the following, but not limited to:
  • the vaccination status of residents, visitors and staff, including the extent of 2nd vaccinations
  • any testing of those accompanying the resident or who they intend to meet on their visit out
  • levels of infection in the community
  • variants of concern in the community
  • where the resident is going on a visit and what activities they will take part in while on the visit
  • the mode of transport that residents intend to use
  • if appropriate, residents being accompanied by:
    • a member of care home staff
    • one or more of their named visitors, and/or
    • their essential care giver (where applicable)
  • residents maintaining social distance from anyone who is not one of their named visitors, essential care providers, or care staff and, wherever possible, avoiding close physical contact with those who are supporting their visit to minimise the risk of infection
  • residents avoiding crowded places
  • residents avoiding using public transport where possible, especially at peak times; travelling in a family car or private taxi is an acceptable alternative
  • Where visits out are accompanied by a named visitor, the visitor should follow the relevant testing regime in the same way as if they were visiting in. Anyone else who the resident meets as part of an indoor visit should undertake a lateral flow device test and receive a negative result on the day of the visit.
  • Those involved in the visit should take steps leading up to the visit to minimise the risk to the care home resident and others in the care home, recognising that introducing COVID-19 to a care home puts all those who live and work there at risk. This includes receiving a negative test and following good infection control practice including social distancing, hand hygiene, wearing face coverings and avoiding crowded places.

Effective communication:

Adjusting to communicating with a face mask might not be easy for some our residents.  Here are a few tips that might be useful:

  • speak loudly and clearly
  • maintain eye contact
  • try not to wear hats or anything else that might conceal their face further
  • wear clothing or your hair in a way that a resident would more likely recognise
  • some people living with dementia might struggle at first to remember or recognise their loved ones. Staff will work to support residents prior to visits to prepare them for a visit, by looking at photographs of the person who is due to visit and talking to them about their relationship etc.

Mental Capacity:

In making these arrangement the Home will observe the rights of residents who may lack the relevant mental capacity needed to make particular decisions about their needs for visits and visiting plans. It will make all such arrangements in line with individual needs by following best interest’s decision making as set out in the mental capacity laws, and where appropriate in consultation with their advocates or those with power of attorney.

In the event of an outbreak:

In the event of an outbreak, the home will immediately stop visiting (except in exceptional circumstances such as end of life) to protect vulnerable residents, staff and visitors. Essential care givers can continue to visit, but not if the essential care giver or resident are COVID-positive.

These restrictions should continue until the outbreak is confirmed as over, which will be at least 14 days after the last laboratory confirmed or clinically suspected cases were identified in a resident or member of staff in the home.

Visiting will stop for 28 days where there is an outbreak of a variant of concern (VOC) other than VOC-20DEC-01 (Alpha variant) and/or VOC-21APR-02 (Delta variant). When visiting resumes the usual infection prevention and control measures and any enhancements required due to any risks identified following the recent outbreak will need to be followed.

Alternative communication:

If there is a restriction to visits in place, alternative ways of communicating between residents and their families and friends are available through Telephone; FaceTime; Zoom; Microsoft Teams; Google Meet and Email at anytime.  Please feel free to contact the Home directly and one of our dedicated team will be happy to support with scheduling this for you.

Gifts:

Please discuss with the Home prior to your visit any items you wish to bring on your visit.  Only small items that can be easily cleaned are permitted at the moment in order to prevent cross contamination.  For example, a box of chocolates that can be sanitised with wipes.  Please note that these will be set aside for a period of 72 hours before being given to the resident.

 

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