Coronavirus direct payments guidance

In response to the Coronavirus (Covid-19) situation, we have put together some guidance and answers to frequently asked questions for people using direct payments in Herefordshire.

Please check the government's regularly updated guidance for people using direct payments during the coronavirus outbreak for the most recent information and changes. It has frequently asked questions and answers about the use of your direct payment during this time, PPE, testing, training and employment related queries.

For a summary about using direct payments during the coronavirus outbreak visit the government’s guidance on the most important things to know about using direct payments during the coronavirus.

Any advice below is based on the current guidance given by the NHS, but this is a fast-changing situation so visit the NHS Covid-19 pages for the very latest information.

Your direct payment support service will remain open and will continue to provide employment support, payroll and managed account services. Face-to-face meetings and home visits have stopped and your support service may ask you to contact them or send information in a different way. Please contact your provider about this if they have not updated you on how their changes may affect you.

If your personal assistant or agency are unable to provide your care and support as normal and you have explored the options available to you, please contact the direct payment team. They can take details from you to pass to a social care professional, who will work with you to explore possible alternatives and options for replacement care, if required. Call 01432 260060 or email directpaymentadvice@herefordshire.gov.uk

Please contact your payroll or employment support provider about any changes to your responsibilities due to the impact of coronavirus, such as queries about pay or sick pay.

Remember that you can contact your liability insurance provider or ACAS, who will also be able to provide advice.

Everyone should do what they can to stop coronavirus spreading

Our general advice is that it is good practice to:

  • Keep everyone updated on actions being taken to reduce risks of exposure within the household
  • Make sure contact numbers and emergency contact details are up to date for everyone in the household
  • Consider extra precautions for PAs who might be more vulnerable, for example if someone is pregnant, aged 70 or over, or has a pre-existing health condition
  • Make sure everyone knows how to spot symptoms of coronavirus and is clear on any relevant processes, for example sickness reporting and sick pay, and procedures in case your PA shows symptoms of the virus
  • Make sure there are clean places to wash hands with hot water and soap, and encourage everyone to wash their hands regularly as this is one of the best ways we can prevent spreading the infection
  • If possible provide hand sanitiser and tissues for your PA and encourage them to use them
  • Keep up to date with the latest government coronavirus advice
  • Detailed information and advice for the public about what they, and their family contacts, should do can be found on the NHS website (and will be regularly updated). There is some very important detail in the Stay at Home guidance, including at what point people are able to come out of self-isolation

Developing a contingency plan

It is likely that you will already have a plan in place, to ensure your needs can continue to be met if there is a risk of care breaking down, and that you will have covered this in your personalised care and support plan.

We recommend that you review your contingency plan so that you are prepared if any paid or unpaid care arrangements should break down because of Covid-19.

The Government has developed a template contingency plan at annex A that you may wish to use.

Things you may want to consider including within this plan are:

  • If you employ PAs - think about and discuss possible options if your PAs cannot work in their usual way. For example longer shift patterns or additional hours. Your direct payment support provider will be able to help you make sure that you are acting legally with any changes that you intend to make
  • Who else can support you to keep safe, such as extended family and friends, if they are willing and able, and what information, advice or training they may need to do this
  • What possible additional training or support there is for existing staff. This does not necessarily have to be through face-to-face training - it could be through learning from other staff, or learning on the internet

Precautions and prevention

The following actions can help prevent the spread of coronavirus:

  • Promote regular handwashing with soap and water among staff and clients. Use alcohol sanitiser that contains at least 60% alcohol if handwashing facilities are not available
  • Cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands.
  • People who feel unwell should stay at home and should not attend work
  • Avoid touching your eyes, nose, and mouth with unwashed hands
  • Clean and disinfect frequently touched objects and surfaces

Cleaning and waste disposal

When cleaning you should use your usual household products, like detergents and bleach, as these will be very effective at getting rid of the virus on surfaces.

  • Clean frequently touched surfaces such as door handles, handrails, remote controls and tabletops. This is particularly important if you have a clinically vulnerable or clinically extremely vulnerable person in the house
  • Clean a shared bathroom each time you use it, for example, by wiping the surfaces you have touched
  • Store personal waste (such as used tissues) and disposable cleaning cloths securely within disposable rubbish bags. Place these bags into another bag, tied securely and kept separate from other waste. Put aside this waste for at least 72 hours before you put it in your usual external household waste bin
  • Immobile clients who are self-isolating need to have a supply of tissues and a bin or disposable bag to hand at all times for disposal of tissues

Other household waste can be disposed of as normal.

Laundry for those self-isolating

If you or your family deal with laundry:

  • Don't shake dirty laundry. This minimises the possibility of dispersing virus through the air
  • Wash items as appropriate, in accordance with the manufacturer's instructions
  • Dirty laundry that has been in contact with an ill person can be washed with other people's items
  • Dispose of items heavily soiled with body fluids, for example, vomit or diarrhoea, or items that cannot be washed

Accessing Personal Protection Equipment (PPE) supplies

If you are in receipt of a direct payment that is funded by Herefordshire Council and you are experiencing difficulty in obtaining supplies and have exhausted all options, the council will help you to source PPE, including if your Personal Assistant is self-employed. Please contact the direct payment team on 01432 260060 or directpaymentadvice@herefordshire.gov.uk

We can pass this information to the people responsible for commissioning supplies for the social care sector in Herefordshire so they can assist with arranging some supplies for you on a temporary basis.

Information about using the correct PPE

PPE is only effective if it used correctly. Public Health England has produced a number of resources that explain how PPE can be safely used to minimise the spread of infection. View the government guidance on using PPE.

This guidance applies whether you have symptoms of Covid-19 or not. In short, the guidance sets out that:

  • When providing personal care which requires a PA to be in direct contact with you (for example, touching) or when within 2 metres of anyone who is coughing, the PA should use disposable gloves, a disposable plastic apron and a fluid-repellent face mask. Eye protection may be needed if there's a risk of droplets from the individual reaching the PA's eyes (for example, caring for someone who is repeatedly coughing or who may be vomiting)
  • New disposable gloves and plastic aprons must be used for each individual episode of care (for example, washing, directly helping take medication etc), whether the person has symptoms or not. Surgical and fluid-repellent face masks can be worn continuously for multiple episodes of care, providing the PA does not touch or remove the face mask in between each action. Eye protection can also be used continuously, dependent on a risk assessment
  • When the PA's care and support does not need them to touch you, but they need to be within 2 metres, gloves and an apron are not needed but a surgical mask is. For example, when your PA is removing medicines from their packaging, or preparing food
  • If you or any members of your household are in the extremely clinically vulnerable category and have received a letter to shield, as a minimum, your PA needs single-use disposable plastic aprons, surgical mask and gloves. A fluid-repellent face mask is needed instead of a surgical mask, if direct contact is required. See more details on who should be shielding

Covid-19 testing for symptom free personal assistants

If you are a personal assistant (PA) (for testing purposes, this is someone who is directly employed by an individual (or self-employed) to provide care and support to enable them to live as independently as possible), you can now get access to weekly PCR testing if the care you provide requires you to come within 2 metres of an adult over the age of 18 that you support.

Herefordshire Council is also working with partners from across the health and social care system in Herefordshire to ensure that PAs can get Covid-19 lateral flow testing (rapid testing) in a timely and effective way at a number of sites across the county.

PCR testing (for PAs that come within 2 metres of an adult over the age of 18)

If you believe you match the above criteria you will be able to order a supply of PCR test kits free of charge every 28 days, delivered to your home address. This will enable you to conduct weekly coronavirus testing at home.

For full guidance on your key responsibilities, how to order tests, conduct testing, and what the results mean, see the government's page on Covid-19 testing for personal assistants.

If you are having difficulty getting tests, have any questions or need assistance you can call 119.

Symptom-free (lateral flow rapid testing)

We now have a number of symptom-free testing sites available across Herefordshire.

This testing is also free of charge, and can be accessed while you are awaiting delivery of a PCR kit, or where you are required to deliver care due to an emergency and need to be tested quickly. Results will be sent to you via text message and an email (if provided) using contact details you enter at registration. The results are communicated the same day of the test (usually within 30-45 minutes). More information about rapid testing.

Useful sources of training for your PA

E-Learning Health Education England e-Learning for Healthcare (HEE e-LfH) has created an e-learning programme in response to the coronavirus (Covid-19) pandemic that is free to access, without logging in, for the entire UK health and care workforce. This includes those working in the NHS, the independent sector and social care. The programme includes key materials to help the health and care workforce respond to coronavirus. You can also find information about other training for PAs on their website, including training that may be available through the Workforce Development Fund.

Skills for Care also list a range of useful training and information resources for PAs during Covid-19.

Key workers

We have produced a letter for employers to issue to their PAs confirming that they are key workers, as defined by the government guidelines. It also confirms that the funding is from the council to meet their employer's care and support needs. Your payroll/managed account provider can provide a copy of the letter or you can contact the direct payment team.