This week, the Department of Health and Social Care (DHSC) published guidance for care home providers on limiting staff movement between settings in all but exceptional circumstances to help reduce the spread of COVID-19 infection.
The guidance states that providers should not deploy staff to provide nursing care or personal care if those individuals are also providing a regulated activity in another setting. This is for both permanent and temporary staff, including agency and bank staff, staff who work across multiple sites for the same employer and staff who work for more than one health and social care provider.
The DHSC said staffing requirements should be planned so routine movement is not necessary to maintain safe staffing levels and that mitigations, such as block booking, should be used to further minimise staff movement where an agency or other temporary staff are needed.
Should a provider need to deploy an individual who usually attends two settings, the new guidance says the provider should ensure there is a 10-day interval between the individual attending the two settings and require a negative test result prior to the individual entering the home. DHSC said that this should be followed in 'all but exceptional circumstances.’
The DHSC has defined these exceptional circumstances by saying, ‘These circumstances arise where a provider has planned its staffing requirements in accordance with CQC fundamental standards and is actively taking steps to address any ongoing resourcing needs but is still unable to ensure sufficient staff are available to deliver care safely.’
The latest guidance states that all providers should complete the Capacity Tracker question 1.2 on staff movement, in accordance with the required reporting arrangements. ‘Where providers have some staff movement under the exceptional circumstances described in this guidance, they should select the answer option, ‘No – we have some staff working between services/settings, but we have exhausted all reasonable steps to ensure we have sufficient staff to provide a safe service’.
Care England has written to the Department of Health and Social Care (DHSC) to express immense frustration with the publication of the staff movement guidance.
Professor Martin Green OBE, Chief Executive of Care England, said, ‘The adult social care sector received no forewarning as to when this major piece of guidance would be issued or what it would look like. The sector is juggling a great many pressures and this unexpected guidance may well have unintended consequences.’
Care England holds that the decision to stop staff movement between care settings will struggle to work in practice and has outlined a number of outstanding issues including:
- Unworkable requirement for providers to ensure that there is a 10-day interval between a member of staff attending two care settings.
- Lack of clarity around the date of implementation.
- No discussion as to how this policy will be funded post-March.
- Growing gap between what the Infection Control Fund is intended to cover versus what it can actually cover.
- No clarity about what constitutes an ‘exceptional circumstance’.
- No guidance as to what the role of the CQC is with regards to enforcing the guidance.
- No reference to the COVID-19 vaccinations and what this means in the longer term.
Professor Martin Green OBE, added, ‘This represents another bureaucratic hoop for providers to jump through. We are at a loss to understand why if these measures are to be introduced across adult social care settings, the movement of NHS staff between NHS settings is not being subjected to the same policy.’
Visit the UK Government website to read the guidance in full and more detail on testing and movement of staff.