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.
Do you have any advice for me regarding loss of earnings if I need to self-isolate and/or close my business temporarily?
We understand this is a deeply worrying and difficult time for many of our providers. We would encourage you to visit the Business Wales website that lists the financial help and support available for those businesses impacted by COVID-19.
What COVID-19 notifications are required by CIW?
You should notify CIW of confirmed and suspected 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). By suspected, we mean people showing symptoms of the virus (new continuous cough, high temperature or loss or change to your sense of smell or taste).
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. You must also notify Public Health Wales.
More information can be found on the Public Health Wales website.
What changes have been made to the death of a service user notification and why?
We have amended the online form for notifying us about the death of a service user to include coronavirus (COVID-19) as a cause of death.
We have made this change to enable us to provide more accurate summarised data on deaths of people using social care services related to COVID -19.
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.
If CIW receive concerns about staffing levels, will they issue non-compliance notices or will they take circumstances into account?
We appreciate that this is a very difficult time for providers. The safety and well-being of people remains our priority. We will be reviewing each concern as reported and will take a proportionate and considered response. If we believe a provider was not taking appropriate measures to mitigate this risk, we would consider taking enforcement action.
If providers have any concerns about their ability to deliver the service safely, they are urged to contact us to discuss these with us.
Can services recruit temporary staff without full checks?
We are aware checks for temporary staff is an area of concern. We are currently in discussion with Welsh Government about the possibility of legislative changes to assist with this matter.
Will providers have the ability to move staff between provisions? For example non-registered care home staff delivering care within Domiciliary Care. Or Day Services staff in LD delivering care in Supported Living?
In the current situation, we recognise providers may need to move staff between services to ensure the safety and well-being of people. It will be important for staff working in unfamiliar services to be well supervised and supported.
Should staff training and development continue?
In these exceptional times we understand staff learning and development will not be a high priority as your focus will be on keeping people safe. Newly recruited staff will need to have induction; we realise it might not be possible to complete the full Social Care Wales induction framework at this time. Training should reflect the needs of people who use the services and ways of delivering training may need to change. We would expect all staff to have supervision, support and oversight, but this is particularly important for new staff and volunteers.
How will providers manage to get all staff registered with social care Wales when they are recruiting high numbers of additional staff to respond to the coronavirus emergency?
We have been liaising closely with Social Care Wales (SCW) and have agreed to extend the registration period before member of staff needs to register from 6 months to 12 months, in order to allow people extra time to complete their requirements. SCW has also extended the confirmed competence eligibility which should make things easier for more experienced staff members returning to the sector.
Is it okay to share staff with other services in our area?
You may need to work collaboratively with other providers in response to COVID-19 and we support partnership working. It is important to make sure staff have been safely recruited and are competent to support the people who use your service.
Have the requirements to have DBS changed?
The Disclosure and Barring Service have announced temporary arrangements to provide DBS checks and fast-track emergency checks of the Adults’ and Children’s Barred Lists, free-of-charge for health care and social care workers who are recruited in connection with the provision of care and treatment of coronavirus. These arrangements will provide employers with the option to appoint new recruits into regulated activity with adults and/or children, as long as the individuals are not barred and appropriate measures are put in place to manage the individual until the full DBS check is received.
Is there leniency with obtaining references when recruiting staff? As we know, it is usually DBS and references that hold up new starters.
We would expect all reasonable steps to be taken. A verbal reference could be taken while waiting for a written response.
How can I provide support to staff if I am social distancing / isolating?
It is important staff are well supported during this very challenging time. It is fine to do this virtually using technology such Skype / WhatsApp etc. A brief record of this should still be kept.
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.
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 this difficult period. However, we do not want an RI visit to increase the risk to people using the service and its staff. We encourage RIs to consider different ways of maintaining oversight.
Can care staff focus on meeting people’s core needs such as personal care, nutrition and medication where COVID-19 is having an impact, for example on staffing levels?
We understand these are unprecedented times and the care and support provided will need to adjust accordingly.
Care staff are being asked by GPs to carry out low level observations (heart rate, temperature, blood pressure etc.) and forwarding these readings on to a GP for decisions? Is this ok?
Yes, as long as the person taking the observations is competent to do so and at all times the requesting clinician takes full responsibility for interpreting these observations and making decisions on clinical care and treatment.
Is it okay for community nurses to delegate tasks to care staff such as changing dressings?
Delegation of nursing tasks such as wound dressings should only be done when care staff have been trained and be deemed competent to undertake the task. Please review the delegation guidance developed for health and care staff. If there is inappropriate delegation the social care worker should refuse to undertake the task and the matter should be escalated. In escalating the matter to senior managers, it should be to request the appropriate training and support rather than an outright rejection of supporting care that the person needs. During this pandemic, it is important for health and social care teams to work together to ensure no patient/resident is harmed through inappropriate action or omission of action.
I have submitted an application to register/vary a RISCA service, will you be able to register this quickly?
We have streamlined our registration / variation process and are prioritising this work to create capacity in the sector. Guidance on our adapted processes can be found on our website.
Will providers of RISCA services be required to submit an annual return in May 2020?
In light of the current pressures on social care providers due to the COVID-19 emergency, Welsh Government have agreed to delay implementation of the annual return requirement by one year, to May 2021.
You will not be required to complete an annual return in 2020.
Will CIW enforce the regulations around to pre-employment checks including DBS for social care staff, nursing staff and volunteers?
We recognise in these exceptional times, the sector will need to be agile in recruiting additional staff to ensure services can continue to be delivered.
In response to coronavirus (COVID-19), the Home Office and the Disclosure and Barring Service (DBS) have put temporary arrangements in place, to provide DBS checks and fast-track emergency checks of the Adults’ and Children’s Barred Lists free-of-charge.
This will apply to healthcare and social care workers being recruited in connection with the provision of care and treatment of coronavirus in England and Wales.
Further details can be found on the UK Government website.
Can I create capacity by turning a lounge or storage room for example into a bedroom?
We understand the need to create additional capacity. Where providers wish to convert existing spaces into bedrooms, this would involve an increase in their maximum numbers. Therefore providers must apply to vary their conditions of registration to increase their maximum numbers. This can be done via CIW online and would involve uploading a revised statement of purpose and a subsequent conversation with an inspector.
We will prioritise these applications but must consider them on a case by case basis given the unique nature and circumstances of each care home.
When applying for a change in maximum numbers, providers will need to consider the legal limits on the number of people who can be accommodated in a shared room.
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.
Are we able to use shared rooms to help create capacity?
The Welsh Government has given consideration to the relaxation of some of the regulations under RISCA, to assist the sector at this difficult time. Information about the legislative changes can be found here. These amendments do not currently include any relaxation to the regulatory requirement around the use of shared rooms.
Are providers expected to support families to maintain contact with people living in care homes?
Guidance (External link) has been issued about considering different ways to help families to maintain contact whilst there is a need to maintain social distancing. This can include letters, phone calls and Skype. It's important to consider the timing of this for families who may be working.
Can we allow families to visit when a person who lives in a care home is at the end of their life?
Where it is safe to do, next of kin should be supported to visit their family member, one at a time, at the end of life. It is important to follow public health guidance on social distancing and good infection control with the provision of PPE if required.
If my nominated online assistants are unwell, can I nominate more people?
We encourage all providers to nominate several online assistants to ensure you are easily able to share information with us. To find out how to set up an online assistant, click here.
This is not applicable for Childcare & Play services.
Should we have DNACPR in place for everyone in our care home?
Decisions about advance care planning, including DNACPR, should always be made on an individual basis. Where a person has capacity, it is important an advance care plan is discussed with them directly. Where a person lacks capacity to engage with the process then best interest guidelines should be followed with the involvement of their family as appropriate.
Advance care plans, with or without DNACPR, should never be applied to groups of people.
Should care staff now be wearing PPE to care for people?
PHW advice should be followed. As it is now considered there is sustained community transmission across the UK, the guidance was updated on 12 April. It contains enhanced PPE recommendations for a wide range of social care contexts. PPE should be used as set out Table 4 of PHW guidance sets out what used. Additional guidance on how to work safely in care homes can be found on the UK Government website.
Do we have to apply for DoLS authorisation if caring for someone with / suspected of having COVID-19 means they need to stay in their bedroom?
Where life-saving treatment is being provided in care homes or hospitals, including for the treatment of COVID-19, then this will not amount to a deprivation of liberty, as long as the treatment is the same as would normally be given to any person without a mental disorder. This includes treatment to prevent the deterioration of a person with COVID-19. For more detail please see the guidance published on 9 April "The Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) During the Coronavirus (COVID-19) Pandemic"
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.
What is the guidance for homes with nursing care not having a RGN on site at all times and no agency/relief nurses available?
Nursing support must be provided where people have been assessed as having nursing needs. If a service provider has exhausted all options they should contact commissioners (local authority and health board) for assistance; CIW should also be notified. Where possible this should be done at an early stage of identifying difficulties. It is also important to put staff who have symptoms forward for testing.
If a registered manager is unwell, is there any scope for another manager covering more than one service?
If a registered manager is unwell or self-isolating, the provider should put interim management arrangements in place. If the manager is absent for more than 28 days the responsible individual should notify CIW using CIW Online.
Under regulation 69, a manager can be appointed to manage more than one service, but this must be discussed with us.
What is the expectation on domiciliary care agencies to keep their office open?
The service needs to be able to continue to operate and have in place alternative arrangements for supporting staff and provision of supplies. People in receipt of services should be informed of alternative contact arrangements. CIW should be informed of these changes.
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.
Specific questions relating childcare and play services
Now that schools are shut, will childcare providers eventually be forced to shut as well?
Welsh Government has announced that childcare will be reserved for the children of critical workers and vulnerable children. You can read more about this here
Will childcare providers be able to increase their overall numbers?
Welsh Government wishes services to be working with a smaller number of children of critical workers only. We consider it unlikely that any service will need to increase the number of children cared for. If you do want to increase the numbers of children you care for you will need to submit a variation via CIW Online.
Can children be looked after by DBS-checked volunteers to enable parents to work, for example in a crèche in a workplace or office?
If this childcare is unpaid, and people looking after the children are unpaid volunteers, then this would be exempt from registration. If there is any reward for providing the care, it would need to be registered.
First aid courses have all been cancelled and so I’m worried I cannot renew my certificate.
We recognise these things will happen. We would expect you to do it as soon as courses resume.
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.
Can I mind children if only one parent is a key / critical worker?
Welsh Government is advising if one parent is a critical worker but the other parent is not then the other parent should provide safe alternative arrangements at home when possible.
During Coronavirus related closures, can I continue to charge parents where their children are not attending my setting?
The Welsh Government acknowledges that, in many cases, the insurance that early years providers have will not cover you for income lost during the COVID-19 related closure. Welsh Government is asking you as a childcare provider to be reasonable and balanced in your dealings with parents. You may also need to consider individual contract arrangements. The Welsh Government is keeping what further support businesses may require under close review.
If a Nursery has furloughed staff, including members of management team, do we need to send a notification?
Not unless it affects ratios/staffing or it means that the service is now closed.
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.
For more information visit the coronavirus information area of our website. If you have any questions regarding coronavirus (COVID-19) not currently included in the above FAQ's please use get in touch with us.