Director of Public Health annual report (2020-21)

The pandemic presented significant challenges for people living in care homes as well as their relatives and staff providing care. Care home residents are at elevated risk of contracting the virus (and experiencing poorer health outcomes as a result) due to factors including age and higher prevalence or increased complexity of long term health conditions. Lockdown and infection control measures can also impact on the mental and physical wellbeing of care home residents due to disruptions to social interactions, use of personal protective equipment (PPE) and changes to routine. Professionals working in care homes also experienced heightened exposure to the virus due to the very nature of their work. Care workers often need to have close physical contact with the people they care for, often within the same building or facility, thus increasing the potential likelihood of virus transmission.

Care home support

Considering the increased susceptibility to the virus of people living and working in care homes, particularly at a time of advancing outbreaks and rapidly evolving national guidance, Wiltshire Public Health worked closely with Adult Social Care to provide care homes and providers with the help and support they needed. The COVID Support Team, led by Adult Social Care in partnership with BSW CCG and the Care Quality Commission (CQC), was quickly established as a single point of contact for care homes, available seven days a week. Upon notification of a case, the team provided regular welfare calls to care facilities to ensure that infection prevention and control standards were maintained, staffing levels were managed and any other operational issues were resolved quickly to enable homes to focus on outbreak management activity. The team engaged with every care home in Wiltshire and continues to conduct telephone welfare checks with homes to ensure they feel supported.

The COVID support team and the PHE Health Protection Team have been so helpful and supportive, they have been at the end of the phone whenever I have needed - giving advice but sometimes just listening 
Wiltshire Care Home Manager

The Adult Social Care team, supported by Wiltshire Public Health, hosted frequent webinars available to all care providers (including care homes, learning disability and domiciliary care services) to share updates, best practice and advice in relation to specific or more complex queries. To date, over 300 providers have positively engaged with this and benefitted from specialist sessions covering infection control and PPE, advanced care planning and dementia and wellbeing support.

Throughout the course of the pandemic, Wiltshire Council, in partnership with the Local Resilience Forum (LRF) have supplied PPE free to care homes in the event of shortages or breakdowns in local supply chains. So far, more than 57,000 type IIR masks, over 21,000 pairs of gloves, and almost 19,000 aprons have been distributed.

They helped me out for many weeks with provision of masks. Without this I really don't know how I would have got through.
Wiltshire Care Home Manager

Wiltshire Council further collaborated with BSW CCG to offer all care homes across Wiltshire the infection prevention and control 'Train the Trainer' programme. This national initiative covers the use of PPE and testing procedures and is provided by local trainers who have received national training. The training is delivered remotely and cascaded to all staff working within the home.

Wiltshire Public Health supplemented the national training by offering and providing care homes with infection, prevention and control calls or visits. These aimed to help care providers ensure they had the correct infection control practices, procedures and policies in place to limit the spread of the virus and advise if any changes were required.

It has been a significantly challenging year for those working in the care sector and the hard work continues to maintain COVID-19 secure environments as well as the same high standards of care that were in place before the pandemic. The mechanisms providing support and advice as described above, coupled with increased testing and the rollout of the vaccination programme from December 2020, meant that care homes were able to offer safe visiting to residents when it was appropriate, providing important connection for relatives and loved ones.

The valuable collaboration and cooperation between individual care providers, Wiltshire Council, BSW CCG and the Wiltshire Care Partnership has provided opportunities for the development of both bottom-up and top-down solutions to the challenges presented.

Key learning identified as a result of the response to COVID-19 is being captured through a series of events in 2021 with a view to sharing and embedding best practice in future business planning.