In response to the coronavirus (COVID-19), we have captured some of your most frequently asked questions for care providers and staff across Wales.
We understand and appreciate the difficulty of the current situation and the impact it is having on many care providers and staff across Wales. We hope the FAQs below answer some of your questions, and we will be updating these regularly as the situation progresses.
Where can providers find the latest guidance and information on COVID-19?
Providers are encouraged to visit the Public Health Wales website for the latest information. We also encourage you to visit the coronavirus (COVID-19) area of our website, as it holds useful links and information.
Social Care Wales and Welsh Government have a lot of resources to guide you. Also, as part of its working programme for supporting care homes to improve the quality of care for older people across Wales, Improvement Cymru have developed the following as a single point of access for information relating to care homes.
What COVID-19 notifications are required by CIW?
You should notify CIW of confirmed cases of COVID-19 of people using the service, and members of staff (and in the case of childminders, other family members living at the premises).
Domiciliary Support Services employing large numbers of staff can notify us about multiple members of staff in a single notification. Such notifications must not be less frequently than weekly. We would expect to be informed immediately of issues regarding the quality of the care provided or risks to people receiving the service.
Please use CIW Online to notify us and report as you would any infectious disease. If your childcare and play service (including childminders) is now closed please inform us, the relevant notification can be found under “Leadership and Management” on CIW Online.
More information can be found on the Public Health Wales website.
How can we socially distance when at work?
The well-being of staff is critical but where a service is responsible for looking after or working with children or vulnerable adults, it would not be reasonable to institute rigid physical distancing. The safeguarding of children and vulnerable adults should not be compromised. However, where possible staff should maintain 2m distance from each other e.g. during breaks.
Guidance for Taking reasonable measures to maintain physical distancing in the workplace can be found on the Welsh Government website.
Specific questions relating to those care services registered under the Regulation and Inspection of Social Care (Wales) Act (RISCA)
Do Responsible Individual's (RI) visits and oversight need to continue?
It is especially important for RIs to maintain oversight of services during the pandemic, monitoring quality and outcomes for people. RIs should ensure they find ways of speaking to people receiving services about their experience.
There is pressure to accept new admissions to care homes to create capacity in hospitals. Do the requirements under regulation 14: Suitability of a service still apply in this time of emergency?
Yes, the requirement under regulation 14 still applies. A provider must be satisfied they can meet a person’s needs before agreeing to provide the service. This decision must take into account the new resident’s needs, existing residents’ needs as well as the provider’s ability to meet those needs within the resources and facilities they have available.
In these exceptional times, the way the provider makes that determination may change. For example, this could include a discussion with a trusted assessor to gather information about the person’s needs, any assessments undertaken by health, risks and the person’s wishes and feelings. The provider would then make their decision based on this discussion, which might be helpful to record.
Updated guidance on hospital discharge was published on 29 April which sets out how people should be safely discharged from hospital.
What do we do if we cannot obtain sufficient staff to safely meet people's needs?
It is important to have a business continuity plan in place; if having explored your options, you are worried about maintaining safe staffing levels, you should alert the local authority (and health board if they also commission care) as early as possible. You should also notify CIW using online notification and can also phone for advice. Registered nursing support must be provided where people have been assessed as having nursing needs. Decisions should be risk assessed and taken in the best interests of people receiving care and should be clearly recorded, including steps taken.
Can family members or volunteers help to provide care?
We would expect providers to have carried out appropriate checks, and be confident the family members or volunteers can carry out the tasks allocated to them safely. We also expect family members and volunteers to be appropriately supervised. COVID testing should be carried out in line with guidance.
Do I have to get staff and people living in the care home tested for COVID-19?
Testing is an important way of managing the spread of COVID-19. Providers should follow Welsh Government guidance and facilitate testing, even where people are asymptomatic. The safety and well-being of people must come first.
No blanket decisions should be made on behalf of people. If people do not have the capacity, individual best interest decisions should be made in line with the Mental Capacity Act. Additional guidance for best interest decisions on the Mental Capacity Act can be found on the Social Care Institute for Excellence website.
Should care homes admit someone new to the home when they have had confirmed cases?
PHW advice is the care home should be free from COVID-19 for 20 days for both an incident or an outbreak as long as by day 14 of the last onset of a case, all staff and residents have tested negative and the outbreak is deemed under control. Please read the guidance to Prevent COVID-19 Among Care Home Residents for details
What is the guidance about people living in a care home or supported living receiving visitors?
Staying connected with friends and family is really important for people’s well-being and should be supported wherever it is safe to do so. Visits in exceptional circumstances, including but not limited to end of life, should be facilitated at all alert levels. Window visits can still take place if a care home has a COVID outbreak. You can read the visitor guidance here for care homes and for supported living. This should be read alongside the control plan which outlines the guidance at each Alert Level.
Has the guidance around hospital discharge changed?
Yes, here is a link to the new guidance. RIs/Managers should note in people’s personal plans that discharge has taken place in line with this guidance. For example, this could include asking for written confirmation that all relevant steps in the guidance have been followed.
What is the process if people living in a care home do not have capacity to consent to the COVID vaccine?
Care home providers should plan to gather consent from relatives or legal power of attorneys for people they consider unable to provide informed consent for themselves. This information should be noted if verbally received, so it can be shared with the vaccination teams on their arrival to minimise disruption to the vaccine delivery.
Health boards have guidelines to follow which includes requesting care home providers obtain this information ahead of the vaccination programme coming to the care home.
If there is no-one to provide consent on the resident’s behalf, health board professionals will speak with the care home manager about the person and undertake the best interest decision. This should be recorded in the person’s personal plan.
For further information please review:
- Additional guidance on the Mental Capacity Act (2005) (MCA) and deprivation of liberty safeguards (DoLS) during the coronavirus (COVID-19) pandemic
- Webinar: MCA and COVID vaccinations in care homes provided by the Social Care Institute for Excellence (SCIE)
- Resources for health and social care professionals - Public Health Wales
Where can I find guidance on prevention and management of COVID-19 in care homes?
Please see links below for updated PHW Guidance on the prevention and management of cases, incidents and outbreaks of COVID-19 in residential settings in Wales.
Can staff working in supported living be tested?
Providers of intensive levels of care and support for people in supported tenancies can now register with the online portal for regular PCR testing (in line with the published control plan). CIW wrote to all relevant providers on 14 December setting out how to do this.
Specific questions relating childcare and play services
As a childminder if I develop coronavirus and temporarily stop minding, can I do a deep clean and then reopen after self isolating?
If you or someone in your household develop symptoms at any time, you should follow the latest Public Health Wales guidance and self-isolate for the recommended time period. You should inform the parents of the children you mind. When the isolation period comes to an end, providing that everyone within the household is then well, there is nothing to prevent you from starting to mind children again.
If your childcare and play service (including childminders) is now closed or has reopened please inform us, the relevant notification can be found under “Leadership and Management” on CIW Online.
What are my options if I do not want to run my service at the moment?
It is important to ensure you take the course of action most suited to your circumstances. Below is a list of options available via your CIW Online account:
Cancellation - you should only choose this option if you have decided that you no longer wish to be registered and have no intention of continuing to run your service in the future. You can do this by using your CIW Online account to apply for a variation to ‘Remove a Service’. Should you want to start operating again in the future, you will need to apply for registration.
Suspension - You should use this CIW Online notification if you wish to stop running your service for a set period of time, for example, a childminder taking maternity leave, or a daycare service closing for repairs to the premises. You will need to enter the date from which you want to suspend your service and approximate end date for the suspension. You will then be able to extend the suspension or request to lift the suspension through CIW Online.
Temporary Closure due to COVID-19 - This CIW Online notification should be used to inform CIW if your service is closing temporarily as a result of COVID-19. Once you are ready to re-open your service, you must inform us via CIW Online.
If a setting is located in a school do they need to inform CIW if there is an outbreak in the school?
No. If there is an outbreak at the school a setting is based in, the setting does not need to notify CIW. CIW notification is only required where there is a confirmed positive case of COVID-19 at the setting itself.
If any staff or children at the setting are identified as contacts of a positive case in the school (or elsewhere), contract tracing advice should be followed.
If a child minder’s household member is self- isolating should they close their service?
If a member of a childminder’s household is asked to self-isolate due to having COVID-19 symptoms, the whole household must self-isolate for 10 days (or until the symptomatic individual receives a negative test result) and the childminding service should close for this time.
If a member of a childminder’s household is asked to self-isolate due to being identified as a contact of a positive case, childminders are advised to contact their local Environmental Health Teams or PHW Health Protection Teams (0300 00 300 32) for advice. In this circumstance, advice will be specific to a childminder’s individual circumstances and the mitigating actions that can be put into place.
What has changed for childcare and play services since level 4 restrictions came in on 20 December 2020?
For more information visit the coronavirus information area of our website. Additional questions received by us between March – June 2020 can be found from the downloads section below. If you have any questions regarding coronavirus (COVID-19) not currently included on this page please get in touch with us.