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26 Nov 2020

DHSC has published updated Covid 19 Guidance for supported living services and clarified that:

The guidance is primarily for supported living settings, but many of the principles are applicable to extra care housing for older people. It may also be a useful resource for the wider supported housing sector, such as retirement or sheltered housing. Given the different types of supported living and the associated care, support and help for people living there, this guidance cannot be specific to individual locations, and local managers should use it to develop their own specific ways of working to protect people’s wellbeing and minimise risks.

Members should read the whole  guidance note, which is both comprehensive and helpful.  Regarding concerns which have been raised by members, key messages are summarised below. If you have concerns about the guidance please email and we will raise them as part of our ongoing dialogue with DHSC.


Avoid sharing staff between settings

Sharing staff between settings should be avoided to reduce the potential spread of COVID-19 from one setting to another. If a local risk assessment identifies service delivery issues caused by low staffing, then supported living and care/support providers can work with local authorities to establish plans for mutual aid, including limited sharing of the workforce.

Local primary and community health services providers may support with the deployment of volunteers and agency staff where that is safe to do so and provided safeguarding measures are in place.

Maintain oversight of people who are self-isolating

The supported living provider should maintain oversight of people who are self-isolating, and note the arrangements that local authorities, CCGs and NHS 111 are putting in place to refer people self-isolating at home to volunteers who can offer practical and emotional support.

Staff within clinically vulnerable groups

Supported living settings are staffed by a wide range of people and some may be more vulnerable to infection, for example, because they have an underlying health condition. Staff whose health makes them clinically extremely vulnerable are recommended to follow the guidance on shielding and protecting clinically extremely vulnerable persons from COVID-19.

Visitors and Support Bubbles

  • visitors should be encouraged to keep personal interaction with the person they are visiting to a minimum and remain socially distanced for as much of the visit as possible
  • numbers of visitors should be limited to the current guidance on group meetings to preserve social distancing as best as possible, and consideration given to staggering visits or other options for limiting simultaneous visits
  • if there is not a communal garden area, then visitors should visit the person in the individual’s own room and should be asked to wash their hands for at least 20 seconds on entering and leaving the accommodation. Visitors should take sensible precautions, such as covering the mouth and nose with a tissue when coughing or sneezing (followed by handwashing) or crook of the arm (not the hand) if no tissues are available. Dispose of tissues into a disposable rubbish bag and immediately wash hands with soap and water for at least 20 seconds or use hand sanitiser
  • if in shared accommodation, visitors should avoid (or minimise if avoidance is not possible) contact with other people who live there and staff (with face-to-face contact occurring for less than 15 minutes and at least 2 metres apart). Where needed, conversations with staff can be arranged over the phone following an in-person visit

Testing for patients and discharge from hospital into the community

Some people with non-urgent needs, who do not meet the clinical criteria to reside in hospital, will be discharged for their recovery period.

As set out in the COVID-19 adult social care action plan, any individual moving into a supported living setting should be supported as if they were possibly COVID-19-positive until a 14-day period has passed, even where they have tested negative for COVID-19. Providers will need to follow the relevant guidance for use of PPE for COVID-19-positive people during this 14-day period.

All people receiving hospital care will be tested for COVID-19, and hospitals should share care needs and COVID-19 status with relevant community partners planning the subsequent community care. Supported living environments should ensure that support plans are in place to maintain a supportive and planned transfer and are discussed with the person being discharged, and where appropriate their family and care providers.

If the PCR (swab) test has been performed in hospital but the result still awaited, the person may only be discharged if assurance has been gained that appropriate support plans are in place for the requirements of the 14-day period to be met.