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Image of Temple Island
Remenham Parish
Remenham Parish

Covid-19 Update

Update on services:

Cllr Charles Margetts, executive member for adult social care

 

As with care homes across the country, those in Wokingham Borough have been coping with a very difficult situation during this crisis. People have died of Covid-19 in our homes and our thoughts are with them, their loved ones and the staff who are care for them.

 

During the crisis, we have provided a huge amount of support to care homes, this has included:

  • An improved funding deal for care homes we contract with plus ability to apply for additional temporary funding
  • Help with supply of Personal Protective Equipment (PPE) – 231,000 pieces of PPE have been supplied to our care homes (313,000 pieces in total supplied to our social care providers).
  • Regular advice and guidance  - over 300 calls to registered care homes
  • Testing for staff with symptoms – more than 250 staff tested, plus others who have self-referred themselves for testing via the government website.
  • Offer of access to staff in an emergency Infection control hotline established

As we became concerned that the situation in care homes across the country was worsening, we lobbied our MPs and the Local Resilience Forum for increased testing of those being discharged and for those in homes and for improved supplies of PPE. We increased our support to local care homes, including providing emergency supplies of PPE and sending staff team into homes to support with specific issues.

 

Despite this lobbying and support, Government guidelines continue to allow the potential discharge of patients with coronavirus into our care homes, so we took the decision to stop hospital discharge into our care homes unless the patient has tested negative and been without symptoms or we have assessed the care home and believe it can cope with positive cases.

 

We have established a task force with health care colleagues that visit our care homes to assess and support their readiness to take and manage positive cases and also to ensure they receive all the support they need.

 

This task force has now visited 14 care homes and we are now at the place where some discharges from hospital can take place more safely. I would like to personally thank all care home staff for the immense effort they are putting in to keep people supported”

 

Introduction:

 

Care homes have a vital role to play in Wokingham, especially during the response to the COVID-19 pandemic. Wokingham Borough Council will actively support our providers to manage the outbreak of COVID-19 to ensure the best outcomes for our residents. However, very vulnerable people are coming in and out of care homes and sustained transmission cannot, to some extent, be prevented.

 

Data released by the ONS shows that more than 8,300 people have died in care homes across England from Covid-19, showing a sharp increase in mortality outside hospitals.

 

This report provides an update on data provided by central government and ADASS. The ONS has cautioned that the figures, gathered from death certificates by the Care Quality Commission, may yet be an underestimate because of reporting delays. Care home operators have said the outbreak in care homes is still not at its peak.

 

Care Homes for Older People in Wokingham

 

Care Home in Wokingham are usually run by private or voluntary sector service providers. Private care homes are run for profit by private organisations and individual proprietors. Voluntary sector homes are not-for-profit and are run by registered charities, religious organisations and housing associations; sometimes for particular groups of people.

 

A care home can include:

 

  • care homes, and
  • nursing homes

 

These are standard terms used by the Care Quality Commission (CQC). Nursing homes are care homes where a nurse must be present to provide, or supervise, medical-type care alongside personal care provided. Nursing homes must be registered to provide nursing care. Some care homes have some beds registered as providing accommodation and personal care only and other beds registered for nursing home-type care i.e. a mixture of provision. Each type of home can provide various specialisms or services, for example dementia care. A care home providing dementia care services needs a higher staff ratio, which may be reflected in its fees. However, not every person living with dementia needs a specialist home.

 

There are 23 care homes for older people in Wokingham and we are currently commissioning care from all these homes except one. 95% of the care homes inspected by the CQC were rated as ‘good’ or ‘outstanding’ prior to the outbreak (February 2020) of the virus.

 

Optalis Ltd operates one care home, Suffolk Lodge, that provides residential care for 36 older people living with dementia who need the support of a secure environment and a higher level of care from staff.

 

The type and physical structure of a care homes will have a significant impact on its ability to manage an outbreak and subsequent infection control. For example, self-isolation is far more difficult to instigate within a care home that supports residents with dementia.

 

Roles and Responsibilities

 

Wokingham Borough Council has a responsibility to support the needs of the individual and maintain the financial sustainability of the social care market. It does not have a direct responsibility to manage an outbreak within a Wokingham Care Home. Responsibilities of our partners include;

 

  • Care homes are monitored by the CQC who hold them to account on the prevention and control of infections and related guidance, a document that is commonly referred to as the hygiene code.
  • The hygiene code requires the care home to have somebody responsible for infection prevention and control to act as a source of authority to set and monitor practice standards. This includes the procurement of adequate levels of PPE to manage the outbreak of an infection.
  • Care homes also have a responsibility to report outbreaks of infection to Public Health England (PHE). PHE are responsible for advising on outbreak control and monitoring the outbreak. The CCGs provide infection control advice to the community, primary care and care homes.
  • CQC is responsible for collecting death data from care homes, who are required under Regulation 16 to provide a notification to CQC of any deaths in a service.

 

The Economy

The latest figures from the Office of National Statistics show that Gross Domestic Product (GDP) is down as the UK economy is hit by the pandemic. The UK economy shrank by two per cent in the three months to the end of March, meaning that it is the biggest economic decrease the UK has seen since the financial crash in 2008 and included a contraction of 5.8 per cent in March GDP alone.

With boosting our economy in mind, yesterday saw a series of Government announcements and guidance setting out how businesses and industries might begin to operate again. As well as garden centres and outdoor sports facilities being permitted to open again from yesterday, the Government has published advice on the measures that can be put in place to adapt and manage public spaces including our high streets, town centres and the infrastructure surrounding transport hubs. Five new ministerial-led taskforces have been set up to explore how other, currently closed, industries might reopen in the coming weeks and months. This will also look at how places of worship may reopen. We also have a series of updates on housing and planning, with new measures to restart the homebuying market and construction. More on all of these under the headers below.

Yesterday’s Ministerial updates

Yesterday’s Number 10 Press Conference was led by the Secretary of State for Housing, Communities and Local Government, Robert Jenrick. He was joined by Professor Jenny Harries, Deputy Chief Medical Officer. His briefing focused on the Government’s plans for the housing market and construction. He added that key workers would benefit from a 30 per cent discount on new homes. He also confirmed that the new money for infection control will go to councils but is for care homes

During yesterday’s Prime Minister’s Questions (PMQs), the Prime Minister, Boris Johnson and Leader of the Opposition, Sir Keir Starmer, discussed the outbreak of Coronavirus in care homes. Sir Keir highlighted that while the number Coronavirus cases have dropped, there remains a very high number of deaths due to the disease in care settings. Responding, the Prime Minister agreed there is an “appalling” epidemic in care homes and highlighted how the Government has extended the testing programme.  He went on to announce that £600 million will be put towards infection control in care homes. Backbench contributions of interest to local government focused on homelessness and rough sleeping, and prioritising investing in low-carbon infrastructure beyond the pandemic.

Updated regulations

The Regulations which govern the restrictions facing society were laid before Parliament yesterday. These changes clarify the circumstances in which hotels may provide accommodation to key workers, permit people to leave their homes to visit public open spaces for open-air recreation with members of their households, and permit people to exercise or engage in open-air recreation with one member of another household. They also increase the fines which may be imposed by fixed penalty notice. Garden centres and outdoor sports facilities are added to the list of businesses which may remain open. They also clarify that people can undertake activities in connection with moving home, and they can visit a waste or recycling centre.

Public spaces 

Further to the release of the Government’s COVID-19 recovery strategy, new guidance has been published yesterday looking at the measures that can be put in place to adapt and manage public spaces in order to help social distancing. It focuses on the design principles for safer urban and green spaces, examining a number of practical, and often temporary, interventions that can be undertaken by the owners and operators of public spaces to keep people safe as and when restrictions are relaxed and urban spaces become busier. This includes advice on managing high streets, town centres, the areas surrounding transport hubs and public places around commercial buildings.

Re-opening of businesses

Many economic sectors will need to consider carefully how they can abide by social distancing measures as the restrictions ease before they can safely reopen. Yesterday garden centres were allowed to re-open and, to help them put in place appropriate measures to keep staff and customers safe, the Horticultural Trades Association has produced safe trading guidance for the industry.

The Food Standards Agency has also published guidance to help food businesses better understand how to work safely during this time.

More widely, businesses and shops in indoor environments or with closer contact between people, like pubs, hotels and non-essential retail, will likely have a higher risk of transmission, as is the case with many places of worship.

To develop guidance on how and when these closed sectors can reopen, five new ministerial-led taskforces have been set up, looking at: pubs and restaurants; non-essential retail (including hair and beauty salons); recreation and leisure, including tourism, culture and heritage, libraries, entertainment and sport; places of worship, including faith, community and public buildings; and, international aviation.

Green spaces

New official guidance for the public on using green spaces also makes clear the new rules, in force yesterday, on spending time outdoors and participating in outdoor sports and activities with household members or one other person while maintaining social distancing. The public can drive to outdoor open spaces in private vehicles (but not stay overnight or visit a second home), go swimming in either lakes or the sea providing social distancing is observed, or practice all forms of water sports on open water. You can also find a Twitter video explaining the new rules on Defra’s feed.

Adult social care

At PMQs yesterday, Boris Johnson announced a further £600 million for infection control in care homes, allocated to councils. At the Number 10 Press Conference this evening, Robert Jenrick said this money will also go towards ensuring there is less rotation of staff, ensuring there are named contacts for councils and the NHS, as well as continuing to test staff and ensure they get the PPE they need.

Journalists also asked about the ongoing crisis in care homes, and why some hospitals are discharging patients into care homes who have tested positive for COVID-19. Professor Harries said that this was down to local discretion and there is clear guidance to NHS staff they should be testing patients ready to be discharged.

Test, track and trace

The Department for Health and Social Care has yesterday issued detailed guidance on the process for testing involving all staff and residents of a care home (known as “whole home testing”). Along with this guidance there is a letter to Directors of Public Health and to Directors of Adult Social Services on their role in this, which is to prioritise which care homes should receive whole home testing and to offer support to care homes so that they are able to follow the process of registration and conducting the tests.

Housing and planning

The Secretary of State, Robert Jenrick, has announced a series of measures to restart the housing market. From yesterday, anyone in England can move home if they follow new guidance in line with social distancing advice. All buyers and renters will be able to complete purchases and view properties in person, while estate agents, conveyancers and removals firms can return to work.  

The announcement also includes measures to start building homes again, through a ‘Safe Working Charter’, enabling home builders to return to work safely, such as by staggering arrival times to ease pressure on public transport.

Councils will be provided with flexibility to support smaller developers by allowing them to defer Community Infrastructure Levy payments. This will help smaller developers struggling with their cashflow due to the pandemic, while ensuring communities still receive funding towards local infrastructure in the longer term.

In a written ministerial statement on planning, the Secretary of State set out the Government’s expectations for how the planning system should be operating during the COVID-19 emergency. It states that the current legislation framework allows for virtual hearings, and updates on the Planning Inspectorate’s use of digital hearings and their return to site visits from mid-May. The Government considers that online inspection of documents should be the default position across all planning regimes, and it is actively exploring all options to achieve this. This applies to applications and appeals under the Town and Country Planning Act; Development Consent Orders under the Planning Act 2008; the Compulsory Purchase Order regime and to development plans, including neighbourhood plans and spatial development strategies.

Importantly, councils and developers can now publicise planning applications through social media and the Government will introduce, from tomorrow, temporary regulations to supplement the existing statutory publicity arrangements for planning applications, listed building consent applications and environmental statements for Environmental Impact Assessment development. This means councils can use digital channels in place of letters and leaflets, and the updated regulations suggest a council could also be discharged of its obligation to publish notice in a newspaper if it is not reasonably practicable to do for reasons related to COVID-19.

The Government considers that online inspection of documents should be the default position across all planning regimes, and it is actively exploring all options to achieve this.

MHCLG has also published guidance on planning matters, and specific guidance for local authorities on Community Infrastructure Levy matters and guidance for compulsory purchase.

In a further written ministerial statement on construction, Mr Jenrick expanded on how the construction industry may adapt its normal practices to operate safely during this time. It also states that, with immediate effect, local planning authorities should take a “swift and positive approach” to requests from developers and site operators for greater flexibility around construction site working hours. This is to ensure that, where appropriate, planning conditions are not a barrier to allowing developers the flexibility necessary to facilitate the safe operation of construction sites during the response to the COVID-19 pandemic and to proceed at pace with work otherwise delayed as a result of COVID-19.

Leisure, culture, hospitality and tourism

In addition to the access to green space guidance, Sport England has summarised all of the public facilities for sport and exercise that are now permitted to be open, and those like playgrounds, outdoor gyms and pools that should remain closed. 

The Lawn Tennis Association has published guidance on how to safely reopen tennis courtsincluding infographics to advise communities on what can safely be done. Councils without existing booking systems may wish to explore their free LTA Rally tool, which allows players to book a court, sessions and, when permitted, find people to play against, helping councils ensure their facilities are financially sustainable for the future, as well as supporting participation.

Other culture, tourism, and leisure services are not expected to reopen or be fully restored until a later date, with most services in ‘step 3’ of the recovery plan. That includes library buildings for browsing, although many library services have continued online, or through home delivery. It is likely this step will be reached in July rather than June.

Children and education

The Department for Education has now published an initial planning framework for schools in England, which has been designed to support those in schools and academy trusts, including mainstream, special, and alternative provision, to prepare and decide arrangements for more children returning to school.

The framework has been developed to help school leaders and trusts to start to think through the steps they might need to take to open their schools for more pupils and as a starting point from which schools and trusts may choose to develop their own plans. The Department have emphasised the need for all schools to work with their councils to determine what services they require and agree on any specific arrangements during this period.

Business support

The Self-Employment Income Support Scheme opens for applications yesterday. Self-employed individuals or members of partnerships whose business has been adversely affected by coronavirus will be able to apply for grant worth 80 per cent of their average monthly trading profits capped at £7,500 for a three month period. People will be able to make a claim on a specified day between 13 and 18 May, based on their unique tax reference number.

Businesses with supply chains which rely on Trade Credit Insurance and who are experiencing difficulties maintaining cover due to the pandemic will now be able to get support from the Government. Trade Credit Insurance provides cover to hundreds of thousands of business to business transactions, particularly in non-service sectors, such as manufacturing and construction.

Workforce

The Government has yesterday published new guidance on how holiday entitlement and pay operate during this outbreak.

To support employees who are working from home and need to purchase home office equipment as a result of the outbreak, the Government will introduce a temporary tax exemption and National Insurance disregard. This will come into effect to ensure that eligible expense will not attract tax and National Insurance Contributions liabilities where reimbursed by the employer.

Death Data and Care Home Support

COVID19 Situation Report_12.05.2020_V6_F[...]
Adobe Acrobat document [924.6 KB]

Answers to questions

Covid FAQs May 4th 2020.docx
Microsoft Word document [50.7 KB]

John Halsall

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