The Department of Health has published minimum standards for care homes,4 requiring owners to promote health and maintain access to health-care services, regulated by the Commission for Social Care Inspectorate. During a pandemic period, there may be considerable pressure on care homes to maintain these standards. A pandemic may require homes to deliver additional levels of care without staff or money. CSCI might need to provide advice to this sector on maintenance of standards during a pandemic period; or where standards may be relaxed; particularly around staffing ratios during (and possibly after) the pandemic period.
Those interviewed set out a number of assumptions that should be challenged. Most obviously, most cited they might be reliant on bank or agency staff to cover shortfalls during a pandemic. However, it may be that infection control arrangements in place might mitigate against staff moving between homes; and the bank or agency staff will be under high demand from other organizations and also be suffering high levels of absenteeism. Even if staff are available, it is likely that there will be a significant shortage of clinicians to cover increased need and consideration should be given to which agency could provide this and the model of care.
Care Homes are subject to commercial business pressures in a way that the NHS is not. Thus, there may be a direct tension between sensible infection control advice and economic survival. One worst-case scenario was that during (or following) a pandemic, some owners may see it as not profitable or economically viable to continue in the business and close/sell a home. This would have consequences for the residents of those homes; and knock on consequences for the stability of the sector as a whole, and more broadly health and social care services to recover from the pandemic period.
The continued flow of patients out of hospital (to free up capacity for those that are critically ill) to both home and into care homes will be critical. Without this flow, there is a risk that the health-care system will be less able to cope with pandemic.
The issue of local leadership and responsibility for coordinating planning for response and longer term recovery and (in its various aspects) was seen as crucial. A framework, for supporting care homes to plan and proving information, should be agreed through each district Pandemic Flu Planning Committee. Existing pandemic plans augmented to cover the care home sector, where this has not already happened. Local Resilience Forums should ensure that relevant contingency planning and preparedness has occurred in the care home sector. This Forum provides an opportunity to ensure that stakeholders from both Local Authority and NHS are involved in oversight of contingency planning.
Owing to nature of the business and customer group, planning needs to encompass infection control, case management and business continuity. The economic survival of the individual business (and the broader sector) may depend on sound business continuity planning.
Workshops and other educational activity may help to address some of the gaps in local planning. These might be jointly run by HPA, PCTs and Local Authorities and should include a simple ‘how to’ guide and generic contingency plans that can be adapted for local circumstances. Contingency planning should be applied to the whole supply chain; with a requirement for business continuity built into contracts.
A suggested policy solution would be for a formal requirement for local authorities to support contingency planning for small businesses assessed as high risk (i.e. in which a high failure rate could have significant knock on consequences for the economy and individual mortality/morbidity). This would fit under duty 6 of the Civil Contingencies Act.
กรมได้ทำการเผยแพร่มาตรฐานขั้นต่ำสำหรับการดูแลบ้าน 4 ต้องการเจ้าของการส่งเสริมสุขภาพ และรักษาเข้าถึงบริการด้านสุขภาพ ควบคุม โดยที่คณะกรรมการผู้ตรวจการดูแลสังคม ช่วงระบาด อาจมีแรงดันพอสมควรในบ้านการดูแลรักษามาตรฐานเหล่านี้ การแพร่ระบาดอาจต้องการเพิ่มระดับของการดูแลโดยพนักงานหรือเงิน CSCI อาจต้องให้คำแนะนำภาคนี้รักษามาตรฐานของช่วงระบาด หรือที่มาตรฐานอาจผ่อน คลาย โดยเฉพาะอย่างยิ่งรอบพนักงานอัตราส่วนระหว่าง (และอาจจะหลัง) รอบระยะเวลาการระบาดผู้สัมภาษณ์กำหนดจำนวนจะถูกท้าทาย สุดเห็นได้ชัด ส่วนใหญ่อ้างว่า พวกเขาอาจพึ่งพาพนักงานธนาคารหรือหน่วยงานเพื่อให้ครอบคลุมไขในระหว่างการแพร่ระบาด อย่างไรก็ตาม มันอาจจะควบคุมการติดเชื้อที่เตรียมไว้อาจลดกับพนักงานที่ย้ายไปมาระหว่างบ้าน และพนักงานธนาคารหรือหน่วยงานจะอยู่ภายใต้ความต้องการสูงจากองค์กรอื่น ๆ และยัง มีอาการการขาดงานในระดับสูง แม้พนักงานจะพร้อมใช้งาน มีแนวโน้มว่า จะมีการขาดแคลนแพทย์ให้ครอบคลุมความต้องการเพิ่มขึ้นสำคัญ และควรพิจารณาหน่วยงานที่สามารถให้นี้และรูปแบบของการดูแลCare Homes are subject to commercial business pressures in a way that the NHS is not. Thus, there may be a direct tension between sensible infection control advice and economic survival. One worst-case scenario was that during (or following) a pandemic, some owners may see it as not profitable or economically viable to continue in the business and close/sell a home. This would have consequences for the residents of those homes; and knock on consequences for the stability of the sector as a whole, and more broadly health and social care services to recover from the pandemic period.The continued flow of patients out of hospital (to free up capacity for those that are critically ill) to both home and into care homes will be critical. Without this flow, there is a risk that the health-care system will be less able to cope with pandemic.The issue of local leadership and responsibility for coordinating planning for response and longer term recovery and (in its various aspects) was seen as crucial. A framework, for supporting care homes to plan and proving information, should be agreed through each district Pandemic Flu Planning Committee. Existing pandemic plans augmented to cover the care home sector, where this has not already happened. Local Resilience Forums should ensure that relevant contingency planning and preparedness has occurred in the care home sector. This Forum provides an opportunity to ensure that stakeholders from both Local Authority and NHS are involved in oversight of contingency planning.Owing to nature of the business and customer group, planning needs to encompass infection control, case management and business continuity. The economic survival of the individual business (and the broader sector) may depend on sound business continuity planning.Workshops and other educational activity may help to address some of the gaps in local planning. These might be jointly run by HPA, PCTs and Local Authorities and should include a simple ‘how to’ guide and generic contingency plans that can be adapted for local circumstances. Contingency planning should be applied to the whole supply chain; with a requirement for business continuity built into contracts.A suggested policy solution would be for a formal requirement for local authorities to support contingency planning for small businesses assessed as high risk (i.e. in which a high failure rate could have significant knock on consequences for the economy and individual mortality/morbidity). This would fit under duty 6 of the Civil Contingencies Act.
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