Introduction
This is guidance to allow essential frontline staff to return to work following a negative PCR if they have been asked to isolate due to potential contact with COVID-19. If there is a risk that staff absence would lead to potential patient harm then staff who are fully vaccinated (14 days after their second dose) may be brought back to work ahead of the self-isolation period following the completion of a local risk assessment.
The aim is to support organisations to reduce the pressure we know is being experienced. This risk assessment process should not be seen as a means to bring back all staff that are absent. These guidelines give employers the ‘right to allow’ not to ‘compel’ staff to return to work. Local organisations will need to determine how to record and govern decision making to ensure appropriate application.
The risk assessment process is led by the provider in liaison with adult and children social care commissioners and managers and public health. The appropriate delegated and named individual with management responsibilities will complete a risk assessment following identification of contact with a positive COVID-19 person (staff member or community contact).
This risk assessment will decide if:
- self-isolation is needed
- the staff member can return to work in exceptional circumstances
Staff consent will be discussed and sought regarding this risk assessment process.
Purpose
The purpose of this plan is to support Brighton & Hove adult and children’s social care providers in the event of temporary loss of staff due to the Covid-19 self-isolation requirements which prevents the ongoing delivery of care services within social care.
This plan is for both commissioned and in-house provided care.
It covers:
- residential
- nursing
- domiciliary
- supported living accommodation
- extra care housing
- mental health provision
The risk assessment will be used by care providers. They will notify Brighton & Hove City Council Adult or Children’s Social Care that they have concerns of their ability to maintain a safe service due to the numbers of staff members required to isolate as a result of contact by NHS Test & Trace service or being ‘pinged’ by the NHS app.
Key principles
Important information to remember is:
- self-isolation exemption is the exception not the ‘norm’; all other business continuity measures will be implemented first
- this guidance is only for people who are double vaccinated. Providers will need to find out vaccination status
- risk assessments will be completed by a named individual(s) nominated by the organisation’s management. Authorisation is given the Brighton & Hove City Council Director of Public Health and either
- Director of Adult Social Services
- Director of Children’s Services.
- the process is managed through an Incident Management Team structure. When notification and completed risk assessment form is completed Brighton & Hove City Council will hold an IMT and aim to respond back to the provider within 24 to 48 hours
- all self-isolation exemption decisions will be made on a case by case basis; an assessment will be completed for any staff member the provider is requesting to return to work
- cases where the contact was a member of the staff member’s household are not be eligible for this process, however decisions can still made on case by case basis using a risk assessment process
- risks to the delivery of critical services will be considered against the risks of onward transmission
- a culture of openness and transparency will be maintained; clients or their advocates will be advised of any possible risk to their care and have any concerns documented along with a response to these concerns
- the concerns of other professional colleagues, and other members of staff who work with the individual, will be documented with a response to these concerns
- staff will be able to return to work through choice and not feel compelled
- a risk mitigation plan will be recorded; robust IPC measures will be agreed
- the exemption only applies if you're attending the workplace and travelling to and from it. outside of this individuals are legally required to remain in isolation at all other times
Trigger
As case numbers increase, there may be circumstances where staffing levels fall so low that the safety of individuals needing care is compromised. In these exceptional circumstances, fully vaccinated frontline NHS and social care staff, if identified as a close contact of a positive case, may be allowed to leave self-isolation to attend (including travelling to and from) work.
This should only be considered in exceptional circumstances where there is a risk to health or safety, or the capacity to provide continuing clinical or care services is compromised due to staff absence.
All providers are expected to have a business continuity plan and inform us if service delivery is likely to be compromised, prior to them reaching their business contingency.
Documentation
There must be a systematically recorded assessment of:
- the harm that may occur if the member of staff cannot attend the workplace
- the likelihood of infection from the contact has been assessed, for example, vaccinated, nature of exposure
- mitigations that will be in place to prevent onward infection if the person was to become a case for example, testing, PPE use
- mitigations that have been put in place to protect the most vulnerable (including residents and staff) from a potentially harmful exposure, for example, not working with immunocompromised
Provider risk assessment
Tasks should be completed by the known lead service area. You'll need to make a record of each completed activity to include the:
- name of the person who completed the task
- the date and time completed
- any relevant notes