Supporting care homes during Covid-19
The Covid-19 pandemic raises a new set of challenges for care home residents, their families and the staff that look after them. Care homes will need to rapidly adapt to new ways of working, including accessing healthcare services remotely, caring for residents with complex health needs and providing palliative care for residents. They are also facing significant workforce challenges with many care staff off sick, self-isolating due to Covid-19, or unable to come to work due to fear and anxiety for their own safety.
As Director of Operations at the Health Innovation Network (the Academic Health Science Network for south London) I have been working to provide support to care homes to help them cope with the Covid-19 crisis. This includes developing practical guidance, helping care homes get set up with IT solutions to enable remote clinical support, and ensuring residents have documented their end of life wishes.
The problems facing care homes
The British Geriatric Society has released guidance for managing the Covid-19 pandemic in care homes with 13 key recommendations. These guidelines state that care staff should be trained to check a resident’s temperature and other vital signs such as respiratory rate, pulse rate, blood pressure and pulse oximetry. The ability to do this will assist care home staff and healthcare professionals to prioritise support according to need. Information about residents, including clinical observations, will need to be shared with healthcare professionals working remotely, highlighting the need for robust IT and technology solutions in care homes.
All care home residents should have an advance care plan which sets out the care and support they would like, including their end of life wishes. This can include things likewhere and how they want to be cared for in the last days of their life. This is particularly important during the Covid-19 pandemic as it avoids unnecessary hospital admissions, but most importantly it respects the wishes and preferences of the care home resident. Some residents do not have an advance care plan, and some may have a paper plan, but this may not be readily accessible to the paramedic or other clinicians in the case of an emergency.
What my organisation is doing
In March we spoke to ten care home managers and two local authority officers working in adult social care, to understand what the local need is in south London. We are providing support in the areas where we have the most experience and expertise, working with other agencies in London where possible.
Innovation
We have good knowledge and understanding of various technology solutions for remote monitoring and video consultations, which will enable remote support to care home staff by NHS clinicians. We are working with the Academic Health Science Networks (AHSNs) to share this knowledge and support decision-making in procuring new systems.
Access to nhs.net
Within our own network of health and care organisations in south London, we are providing telephone support to care homes directly to help them get set up on nhs.net – a secure email system which allows care home staff to communicate personal information about a resident securely with NHS staff.
Advance care plans
We are working with care homes in south London to increase the number of care home residents with an advance care plan, through a service called Coordinate My Care (CMC). This allows care plans, including end of life wishes, to be shared securely with NHS hospitals and primary care providers, as well as with the London Ambulance Service.
Connecting with friends and family
We have secured 50 digital tablets to distribute to care homes, hospices and hospitals in south London so that the residents can stay connected with their friends and families via skype or the Facebook portal. This will help to support care home residents who are experiencing isolation and loneliness as a result of social distancing.
Keeping active
We have created a guide to online resources for those caring for older people, including those with dementia.
Supporting care home staff
We are working in partnership with a mental health training organisation to offer mental health first aid training to care home staff. Staff will be able to access a virtual two-hour training session and will have access to ongoing support through an online forum. We have also contributed to the creation of a one-page information sheet for care homes which simplifies all of the guidance, and signposts care homes to relevant organisations for further support. This is being distributed to all care homes in London via the local health system leads (Clinical Commissioning Groups and Sustainability and Transformation Partnerships).
Disclaimer
The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.
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