How local authorities and providers of supported accommodation should manage their settings during the coronavirus outbreak.
It is clear that we are facing an unprecedented global public health emergency caused by the continuing spread of COVID-19. All statutory services have a part to play in supporting the wider humanitarian response and local authorities and providers have a key role to play.
Purpose of the guidance
This guidance is for local authorities and providers involved in delivering supported living accommodation and sets out the need to put practical measures in place to:
- Ensure that those living and working in supported accommodation settings:
- have the support, resources and policies needed to protect themselves.
- have access to the facilities that enable them to adhere to public health guidance on hygiene and isolation.
- Mitigate the risk of infection within supported accommodation settings.
The priority must be the development of an effective local response to ensure people can access sanitation, be effectively isolated and have access to medical and other support as necessary, in order to limit risk of wider infection.
In addition, for people in supported accommodation settings, it is of paramount importance that their mental and physical resilience is considered, especially where people who are already suffering from a serious mental health illness are required to self-isolate.
Solutions to consider in supported accommodation settings
Local authorities and providers should work together to identify the best solutions to issues as they arise, taking joint decisions where appropriate.
The following are a series of practical steps that local authorities and providers should consider when providing support within supported living accommodation.
Prioritisation of schemes and cross-training of staff
Local authorities should identify schemes that require high intensity/24 hour support and ensure that these schemes have adequate staff in the event that provider organisations are operating with significantly depleted staff resources as a result of illness.
Local authorities and providers should, where possible, provide additional training and support to staff enabling them to provide support in different settings, should staffing levels require them to be allocated to schemes they do not usually work in. This may include the use of agency staff, where appropriate.
Access to premises should be restricted by limiting the number of staff attending each project/scheme, and strict adherence to cleaning and hygiene guidance, in order to reduce the possibility of exposure.
Local authorities, where possible, will supply appropriate personal protective equipment (PPE) to staff providing high intensity/24-hour support to tenants who display symptoms of COVID-19. All PPE should be used in line with guidance from the Welsh Government and Public Health Wales.
As the situation changes so rapidly, local authorities and providers should ensure that all staff within supported living accommodation have access to up to date public health information on COVID 19 via the Welsh Government website.
Visitors to the scheme
Any non-urgent visits to the accommodation should be postponed. Where access is required for essential services such as the delivery of groceries or medication or cleaning by third party staff, visitors should maintain a distance of 2 metres from all residents. They should also avoid touching their face and ensure their hands are washed thoroughly once they leave the premises.
Managing those unable or unwilling to self-isolate
Read guidance about dealing with people who are unwilling or unable to self-isolate or follow coronavirus lockdown instructions in supported and temporary accommodation, hostels and people who are sleeping rough.
Where it is not possible for someone to self-isolate due to the physical environment, or due to difficulties in understanding or complying with instructions, providers should look to identify and access alternative accommodation. This should be self-contained accommodation with private bathrooms and support should continue to be provided. This should be done in partnership with the local authority and the centralised coordination cells within local authorities, which have been tasked with coordinating accommodation and support services during this pandemic.
If there are multiple residents across projects that need to self-isolate, services could consider designating one property as a ‘safe zone’ and move all those needing to self-isolate into that one property. Any such decision would need to be considered carefully and guidance sought from Public Health Wales.
Consideration could also be given to re-purposing unoccupied buildings for use as pop-up accommodation. However, any accommodation must provide for the basic needs of the individual, such as suitable hygiene facilities. Any such activity must be undertaken in co-operation with the local authority to ensure co-ordination of similar activities across an area.
Utilising available space in a safe way
Where space for self-isolation is limited, consideration could be given to using office space and bathroom facilities usually restricted to staff to be utilised for those who need to self-isolate. If taking this approach, all paperwork should be secured in line with GDPR requirements, personal belongings removed and access to IT and other office equipment prevented.
Where accommodation-based services are in buildings with multiple floors or wings, zones could be created for separating different cohorts (i.e. people who have symptoms, those in high risk groups and all others).
Living rooms or activity rooms could also be turned into self-isolation rooms. However the impact of reducing access to activity/living rooms on other residents’ mental health and wellbeing will need to be taken in to account.
Shared kitchens and bathrooms
Residents should minimise the time they spend in shared kitchens and bathrooms and should aim to keep 2 metres away from others they live with.
Shared kitchens and bathrooms should be cleaned frequently in line with public health guidance, which also indicates that personal protective equipment (PPE) should be used if a tenant has COVID-19 symptoms.
Residents should be encouraged to clean kitchens and bathrooms after each use, in addition to arranged staff cleaning. Cleaning kits should be provided for this purpose.
Providers could display the poster Cleaning and disinfection guidance produced by Public Health England in prominent areas throughout the property.
- Where possible, residents who are self-isolating should not be allowed to enter a shared kitchen. Instead, their meals should be prepared for them and left outside their bedroom door. If this is not possible, those self-isolating should avoid using the shared kitchen whilst others are present and take meals back to their room to eat.
- If available, a dishwasher should be used to clean and dry used crockery and cutlery. If this is not possible, they should be washed using washing up liquid and warm water and should be dried thoroughly. Separate tea towels should be used.
- You may want to consider providing facilities in tenants’ bedrooms in order for them to prepare basic refreshments/meals to reduce reliance on shared kitchens. However this should only be considered where it is safe to do so.
- Where possible, one bathroom should be designated for residents who need to self-isolate, and cleaned after each use ready for the next person, with other residents within the project using a different bathroom, as per the guidance.
- Rotas could be drawn up for showering/bathing, with the resident(s) self-isolating using the facilities last.
- Bathrooms must be cleaned after each use.
Shared communal areas and outdoor spaces
Residents should minimise the time they spend in shared spaces, such as living rooms and activity rooms, and should aim to keep 2 metres away from others they live with. Shared spaces should be well ventilated and cleaned regularly.
Residents who are self-isolating should not enter shared communal areas.
If residents who are self-isolating wish to make use of shared outdoor spaces, they should stay at least 2 metres away from other residents and staff. To reduce the risk of potential contact, a rota could be drawn up for going outside.
In addition, any communal areas and shared spaces should be cleaned regularly in line with guidance.
Supported living schemes should continue to accept new tenants in order to provide vulnerable people with access to services and support, in line with their standard policies and procedures and where it is safe to do so.
When taking in new tenants, the provider should undertake an initial risk assessment by ascertaining if the new person coming into the accommodation has any symptoms suggestive of COVID-19. If they do, they would need to follow the current national guidance in requesting that person to self-isolate for 7 days because they are symptomatic. If they do not have any symptoms, they should follow the social distancing guidance and maintain hygiene and cleaning practices.
If for some reason they come into the scheme from another home where they have been self-isolating for 14 days (because they were a household in contact with a symptomatic person) then they need not to ‘rewind the clock’, but should continue with their original timescale until their 14 days have finished.
All waste that has been in contact with a person who is a possible COVID-19 case, including used tissues, should be put in a plastic rubbish bag and tied. The plastic bag should then be placed in a second bin bag, tied, and disposed of in the general waste after 72 hours.
If a symptomatic resident leaves the premises, for example, due to the requirement for hospitalisation, then the guidance on handling linens and cleaning should be followed.
It’s good practice to establish a routine and robust cleaning programme, if this is not already in place.
Improving physical health resilience
Staff should work with all residents to make them aware of the guidance and help them to understand the importance of following the guidance.
It is likely that routine GP and surgery appointments will largely be replaced by telephone/online “face-to-face” platforms. For problems that are not related to COVID-19, residents can telephone their GP surgery to discuss the issue. Staff should assist with the ordering and collection of residents’ medication in line with government guidelines.
Residents should be encouraged to self-manage their normal (non Covid-19 related) health conditions wherever possible. In addition, residents should be encouraged to exercise, while complying with government restrictions and the latest public health advice.
Improving mental health resilience and dealing with mental distress
Some residents with serious mental illness, dementia or learning disabilities may not be able to process information regarding self-isolation. In these cases please refer to any guidance from Public Health Wales about managing their inability or unwillingness to self-isolate. Their contact number is 0300 003 0032.
Staff in supported living accommodation should carry out frequent welfare checks on people who are self-isolating, using video calling where possible. Other residents can also be encouraged to make contact with them using online communication tools such as FaceTime/Skype/WhatsApp.
Residents should be encouraged to self-manage their normal (non Covid-19 related) mental health conditions wherever possible.
If there are concerns about residents who are known to a psychiatrist or who are awaiting an appointment with a psychiatrist, the GP should be contacted for advice on the current procedure. For those whose mental health deteriorates to the extent that the staff feel that they cannot manage it, they should again contact the GP.
In the event of incidents of deliberate self-harm, staff should follow the normal protocol. However, if an ambulance is called it is essential that any details regarding the resident’s COVID-19 status is given to the call handler. At this time, please be aware that calling an ambulance or attending an emergency department in cases of threatened self-harm may result in excessively long waiting times or no service at all. In these cases please contact the GP or care managers as appropriate and take precautions to ensure the person is kept safe. The individual may wish to access support by telephone from the Samaritans on 116 123 from any phone, or for young people from Papyrus UK on 0800 068 4141.
If other mental health distress or behavioural issues are being experienced then residents can be directed to resources such as the Community Advice and Listening Line on 0800 132 737, where they can receive emotional support and advice.
Staff who have completed ASSIST suicide prevention training should re-visit the resources from that training to support their decision making in cases where residents are expressing suicidal thoughts. The Samaritans will also be able to provide advice on 116 123.
A written statement on provision for children of key workers was published on 20 March. If children can stay safely at home, they should. However, local authority housing and homelessness officers should work with their education colleagues to ensure that staff providing support within supported living schemes have access to school/childcare places during this time, if required and as a last resort.
We will provide further guidance if the evolving situation requires additional measures. We will also work to ensure that where best practice is identified, this is disseminated across Wales.
Advice on COVID-19 is updated regularly and available on:
Please also note the advice from the Information Commissioner on data sharing.