Novel 19 Coronavirus PPE and Infection control for

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Novel 19 Coronavirus: PPE and Infection control for Adult Care Providers Prof Jim Mc.

Novel 19 Coronavirus: PPE and Infection control for Adult Care Providers Prof Jim Mc. Manus Director of Public Health The webinar will begin shortly www. hertfordshire. gov. uk

Agenda • Background • Adult Social care action plan • High impact Infection control

Agenda • Background • Adult Social care action plan • High impact Infection control measures • PPE • Q&A’s www. hertfordshire. gov. uk

Current position in Hertfordshire Approximately 60% of our care homes have outbreaks www. hertfordshire.

Current position in Hertfordshire Approximately 60% of our care homes have outbreaks www. hertfordshire. gov. uk

Care homes: Key challenges • Residents are most at risk from Covid-19, therefore death

Care homes: Key challenges • Residents are most at risk from Covid-19, therefore death rates are likely to be high. • There is asymptomatic transmission of Covid-19 in care homes in both residents and staff. • • Evidence of second outbreaks in some care homes. Staff, particularly agency staff and visitors are vehicles for imported transmission of Covid-19 into care homes www. hertfordshire. gov. uk

Social care Action Plan 4 pillars of action plan New measures Controlling the spread

Social care Action Plan 4 pillars of action plan New measures Controlling the spread of infection • Continuation of PPE drops through LRFs to continue and further deliveries based on priority needs. • We will be ramping up Testing to cover every social care worker, all symptomatic residents in care homes, all patients in hospital prior to discharge to care homes, and all individuals coming to care homes from the community. • Further guidance on isolation and alternative arrangements for those who need ongoing care. 2 Supporting the workforce • Provision of fully funded induction training (the Care Certificate) in a rapid 2 day, knowledge focused, remote programme. • We are providing managers with the tools to finalise the induction within the setting and support their business throughout the incident • The Care Academy will welcome new practitioners within the setting, aiming to support recruitment and retention and help individuals continue to grow their knowledge and their development • Our ambition is to attract thousands of people into social care in Hertfordshire over the next 3 months. • We have launched recruitment campaign and are funding rapid induction training for those that need it. DBS checks for those helping with Covid effort are also free. • We are also developing a Workforce Rescue Project to fast-track staff into services, including carrying out DBS, referencing and document checking on behalf of providers. • Additional measures to support the existing workforce, including access to counselling and support services 3 Supporting independence, supporting people at the end of their lives, and responding to individual needs • HCPA Health promotion team has created a dedicated page to support with mobility, engagement and wellbeing of individuals – Visit for information here www. hcpastopfalls. info • Care Homes across the county were offered to have Facebook Portals to enable greater links with families and relatives. Some guidance on good practice with video calling is currently being drafted. • A number of resources and webinars have been run to support providers on EOL and Advance Care Planning • HCC have created a number of Easy Read resources for those living with a Learning disability which have been put in to a single place on the HCPA website- www. hcpa. info/guideline/coronavirus-easy-read-guide/ 4 Supporting local authorities and the providers of care • Additional information and guidance on the process and funding in place to provide support to local authorities and providers of care. 1

Ramping up Infection Control measures: High impact actions - Restricting workforce movement - -

Ramping up Infection Control measures: High impact actions - Restricting workforce movement - - Restricting staff rotation from Covid-19 homes to Covid-19 free homes Cleaning and Infection Control - PPE - Contact tracing Isolation - Increased segregation in care homes - Stop all non-essential visits and encourage social restriction amongst staff Testing - Test all staff and residents www. hertfordshire. gov. uk

Infection Control Checklist

Infection Control Checklist

PPE – What is it and why is it needed? It can include items

PPE – What is it and why is it needed? It can include items such as gloves, aprons, face masks, eye protection and hand sanitiser. • protects workers from becoming infected by people with • • infections protects people receiving care, vulnerable to infection, from being infected by workers prevents the spread of infection www. hertfordshire. gov. uk

PPE – Who needs its? • If you are providing DIRECT CARE you will

PPE – Who needs its? • If you are providing DIRECT CARE you will be within 2 meters of an individual so you will need Gloves, Apron, Fluid Resistant Mask • If you are working within 2 metres of an individual but not providing direct care, you will need a mask (see Table 1 for which type). • If you are working outside of 2 metres of an individual, you do not require PPE.

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Using PPE safely • Staff should know what PPE to wear for each setting

Using PPE safely • Staff should know what PPE to wear for each setting and context • Safe working practices are needed when using PPE for people to protect themselves and limit the spread of infection. • Hand washing is required before PPE is put on AND during the removal of PPE as per instructions below. • Staff should be trained on putting on and taking off www. hertfordshire. gov. uk

PPE – Usage Fluid repellent surgical masks / eye protection • Staff can wear

PPE – Usage Fluid repellent surgical masks / eye protection • Staff can wear the same face mask continuously for the whole of a session until they have a break (to drink, eat, take a break from duties or travel on public transport). A new face mask should be used for the next duty period and eye protection must be appropriately cleaned when removed/before next use. • For staff visiting homes, you can wear the same face mask between visits so long as you do not need to take the mask off, or remove it from your face. • You can wear the face mask between symptomatic and non-symptomatic residents. • Face masks should be removed if damaged, soiled, damp, compromised or uncomfortable.

PPE – Usage (cont) Aprons and gloves Subject to single use as per Standard

PPE – Usage (cont) Aprons and gloves Subject to single use as per Standard Infection Control Precautions, with disposal and hygiene after contact with individual children. www. hertfordshire. gov. uk

Putting on PPE safely - You should wash your hands before putting this on,

Putting on PPE safely - You should wash your hands before putting this on, and put PPE on in the following order; • disposable apron • fluid repellent surgical mask • eye protection if risk of splashing to the face or eyes • disposable gloves

Removing PPE safely - It is important that the PPE is removed in an

Removing PPE safely - It is important that the PPE is removed in an order that minimises the potential for cross-contamination. Hand decontamination helps to prevent the spread of infection - use alcohol hand rub or wash hands with soap and water between removing items of PPE should be removed in the following order: – disposable gloves – hand decontamination – disposable apron – eye protection (if worn) – hand decontamination – fluid repellent surgical mask – hand decontamination: wash hands with soap and water for 20 seconds after all PPE has been removed.

What to do in the event of lack of PPE supply We are assured

What to do in the event of lack of PPE supply We are assured that PPE are being produced in the UK and is in supply, but in the event of lack of supply, the flow chart on the right should be followed

Staff Uniform • Staff uniforms and clothing should be protected from contamination by PPE.

Staff Uniform • Staff uniforms and clothing should be protected from contamination by PPE. • Staff should have a uniform or dedicated clothing for work and wash separately from other items in a load not more than half full (washing on hottest wash clothes can tolerate). • Staff are advised to change into and out of uniforms/work wear at work and not wear when travelling to and from work. • Put work clothes into a disposable plastic bag which can be disposed of at home in normal household waste. www. hertfordshire. gov. uk

Disposal of PPE Home Based Care • • Used PPE must be placed in

Disposal of PPE Home Based Care • • Used PPE must be placed in a bag such as a carrier bag by the health/social care worker. This bag must be securely tied closed. If working with a client who has COVID-19 or is showing symptoms, it must be left in a safe place where it will not be handled in the client’s home for 72 hours. The client / household member must be advised to place this bag in a second waste bag after 72 hours, and then place this in their usual domestic waste stream. The PPE should NOT be placed in an orange clinical waste bag or be transported by health/social care workers. Healthcare Settings & Nursing Homes • Waste (including used PPE) from a possible or a confirmed COVID case must be disposed of as Category B infectious waste. The transport of Category B waste is described in Health Technical Memorandum 07 -01: Safe management of healthcare waste. www. hertfordshire. gov. uk

Deep cleaning During outbreak – Enhance frequency of cleaning within care home (touch points,

Deep cleaning During outbreak – Enhance frequency of cleaning within care home (touch points, communal areas, resident’s bedroom, staff room area and equipment) Post outbreak – 14 days post new case, deep clean care home, which should start from the least affected area/unit of the home progressing to the most affected area/unit. This should be spotchecked by a nominated staff member to check the cleaning standards prior to sign off. A combined detergent/disinfectant solution at a dilution of 1, 000 ppm available chlorine or a general neutral detergent in a solution of warm water followed by a disinfectant soltion of 1, 000 ppm can be used (follow manufacturers recommendations on dilution, making and storage) Reducing the risk of transmission of COVID-19 in the hospital setting guidance. Click here. Admission and Care of Residents during COVID-19 Incident in a Care Home. Click here www. hertfordshire. gov. uk

Post deep cleaning checklist • https: //www. hcpa. info/wp-content/uploads/Post-Outbreak-Deep-clean-2020 -v 43. docx

Post deep cleaning checklist • https: //www. hcpa. info/wp-content/uploads/Post-Outbreak-Deep-clean-2020 -v 43. docx

General Infection Control Principles The following are effective strategies to prevent spread of Covid-19

General Infection Control Principles The following are effective strategies to prevent spread of Covid-19 infection - good frequent handwashing for at least 20 seconds when you get home or into work, when you blow your nose, sneeze, cough, eat or handle food or use a hand sanitiser frequently when out and about. avoid touching your eyes, nose, and mouth with unwashed hands cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands clean and disinfect frequently touched objects and surfaces maintain 2 metre social distancing where possible beyond household members.

Last few words – remember the Es • Everyone has a responsibility for infection

Last few words – remember the Es • Everyone has a responsibility for infection prevention and control • Ensure that you are familiar with the principles of standard infection prevention & control in order to protect yourself, residents and visitors • Effective hand hygiene is the single most important strategy in preventing health care associated infections www. hertfordshire. gov. uk

Resources • Latest Covid-19 related information • https: //www. hertfordshire. gov. uk/media-library/documents/public-health/coronavirus/professionals-pages/herts-ppe-home-careguidance-high-covid-levels. pdf •

Resources • Latest Covid-19 related information • https: //www. hertfordshire. gov. uk/media-library/documents/public-health/coronavirus/professionals-pages/herts-ppe-home-careguidance-high-covid-levels. pdf • Local Hertfordshire PPE guidance for social care • https: //www. hertfordshire. gov. uk/media-library/documents/public-health/coronavirus/professionals-pages/herts-ppe-home-careguidance-high-covid-levels. pdf • How to work safely in care homes • https: //assets. publishing. service. gov. uk/government/uploads/system/uploads/attachment_data/file/880094/PHE_11651_COVID 19_How_to_work_safely_in_care_homes. pdf • How to work safely in domicilary care • https: //assets. publishing. service. gov. uk/government/uploads/system/uploads/attachment_data/file/882376/Domiciliary_guidance_ England. pdf • COVID-19: infection prevention and control (IPC) https: //www. gov. uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control • Collection of official advice and guidance https: //www. gov. uk/government/collections/wuhan-novel-coronavirus

REMINDER COVID-19 Care Support Provider Hub W: hcpa. info/covid-19 E: assistance@hcpa. info T: 01707

REMINDER COVID-19 Care Support Provider Hub W: hcpa. info/covid-19 E: assistance@hcpa. info T: 01707 708 108

Q & A www. hertfordshire. gov. uk

Q & A www. hertfordshire. gov. uk