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Latest News from Home of Comfort

Dear Friends,

We are very pleased to let you know that all three rounds of ‘whole home’ testing conducted at Home of Comfort after two staff members tested positive have been completed, and that no further positive results have been received.
The team at Public Health England are satisfied that there has been no ‘in-home transmission’, i.e. that nobody has caught Covid-19 from someone else here, and they have closed their investigation.
They have advised us that it is possible that over the next few months we may see more positive results from staff members if local infection rates continue to rise. As long as we continue to be vigilant about infection prevention and control, and carry out testing according to the prescribed schedule, any future cases will be dealt with in the same way.
[We will now revert to the routine of testing all staff once each week, and residents once every 4 weeks.]

We have now had an opportunity to read the updated government guidance for Visiting in Care Homes (there is a link below if you would like to see it for yourself). These points that we received from the National Care Forum (an organisation representing ‘not for profit’ care providers, like the Home of Comfort), sum the changes up:

Essentially services which are in Tier 2 or Tier 3 areas must return to visiting only in exceptional circumstances such as end of life.
For services which are in Tier 1 there are a number of changes: 
1.    You can now have a maximum of two constant visitors per resident, not just one.
2.    The guidance has strengthened the need for individualized risk assessments and emphasises the importance of the human rights of the individual receiving care. A section has been added on social workers assisting in making these assessments.
3.    It advises care providers to involve residents, families, professionals in the decision making process about visiting.
4.    It stresses the need for visits to take place in well-ventilated spaces.
5.    It stresses that visitors must be supervised at all times to ensure PPE and social distancing guidelines are being strictly followed.

The introduction of Tiers across England means that people living in a Tier 2 or Tier 3 area are not permitted to go into anybody else’s home, which means that we would no longer be allowed to invite anybody living in a place which is in Tier 2 or Tier 3 inside the Home of Comfort. 
Clearly visits in the garden of the Home are becoming more difficult as summer turns to autumn, and we realise that such visitors are likely to be travelling some distance to the Home, so it’s more difficult for them to pop round if we happen to have a day when the sun is shining. 
Unfortunately we are very limited in our options in such cases, but we believe (and we are urgently seeking advice and clarification on this from our local Director of Public Health) that it would still be reasonable to make allowances for end of life visits, as we would consider these ‘emergency visits’ which are still being permitted in settings in Tier 2 and Tier 3 areas. 

The Home does not believe it is necessary just at the moment to make any changes to our visiting policy in respect to local visitors. However, we are sure you will understand that we will need to keep the situation under very regular review, in particular in relation to the 5th point in the list above, something that is explicitly included in the new guidance.
We would be extremely reluctant to closely supervise visits, something we feel would be unfair to residents, visitors, and very difficult for our staff; ‘Policing’ the time that you spend with your loved ones is about as far from the ethos of Home of Comfort as it is possible to get. For the time being, we will continue to ask all visitors a number of questions on arrival at the Home, and we will ‘check in’ during visits to make sure all is well, and we will be asking our DPH for support for this approach.

Lastly, we have (along with all care homes) had a letter from Helen Whatley, the Care Minister, which includes the following message about the testing of visitors:
I hope further peace of mind will come for care staff, residents and visitors following news that we are working up proposals with clinicians and stakeholder groups to run a new visiting scheme.
This scheme will allow specific or designated care home visitors, who provide regular personal care, to attend residential settings multiple times a week. We hope this will help reduce feelings of isolation among residents and provide additional support to care staff.

We are hoping to hear more about this within the next few weeks, as it may offer us a way to keep visits going if – as I am afraid we are expecting – we see further restrictions on aspects of normal life in the coming months. It is something we expect to be introduced gradually, and we are doing our best to prepare, though there are a lot of details we do not have about how it might work.

If you are watching the local figures, you will notice a very steep rise in the infection rate in the city; this was in line with the rate across Hampshire but is now double the rate in the rest of the county. A week ago the estimated infection rate in Portsmouth was 64 cases per 100,000 population and it is now 116 per 100,000.
We were briefed yesterday (by our local Director of Public Health or ‘DPH’) about these figures, and about a number of factors which make them less troubling than they initially appear, but still concerning.
At present, the majority of local cases are still occurring in people under 30 years of age, and most are found in the student population and through testing at the naval base. Part of the steep rise in cases is due to high numbers of tests being conducted in both of these locations.  At present, the number of cases in locations such as care homes and schools is small, and the cases that are coming to light are being successfully contained. Data from health services indicates that there is so far only a small increase in measures such as hospital admissions for respiratory problems. 

However, there is no doubt that the general level of infection in the community is rising, and it is likely to continue to rise. So far, the official advice that our DPH gives to care homes weekly is that there is no need for care homes to consider new restrictions on visiting, but we are expecting this to change, potentially as soon as this week. A revised statement is issued to care homes in the city each Friday.
Through the care provider member associations we are part of we hear that, having perhaps not done enough to safeguard care home residents in the first wave of Covid-19 infection, the most senior figures in the government are now very anxious to minimise risk, and favour an almost complete suspension of visiting across England.  Helen Whatley, who is the Minister, is more sympathetic to the impact this would have on residents and their loved ones, but it is likely to become more difficult for homes to keep visits going, for a number of reasons. (One of which is that, unlike the NHS, care providers have not been indemnified against Covid related liability claims.)

The Home has always had a very open visiting policy and to find ourselves in these constrained times is challenging. We appreciate that it must be so difficult for everyone not to be able to spent the time together that would normally be possible, and we know the rules are a lot to bear. In return, we can only promise we will do our very best to keep visiting going at the Home, even if only in the current very limited form, for as long as we possibly can.
If you have any questions in the meantime please do not hesitate to ask. 
With best wishes
from Robin, Deepa and everyone at Home of Comfort

Links if you would like to read further:
National Winter Plan for Adult Social Care
Care Home Visiting Guidance, updated on 14th October
Home of Comfort’s Current Visiting Policy
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And our past newsletters are here


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