Weekly update – Monday 14th December 2020

Here we are again and only 11 more sleeps till Christmas Day or perhaps only 10 more doors to open on your Advent calendar. Every family has their own Christmas countdowns, some old favourites and some new. But, however you mark the nearing occasion, we are getting close.

This week has with no surprise been a Christmas Week. Even through we have so many decorations already, a few more can never hurt, so Monday was a day spent drawing and colouring festive designs for around the home. Tuesday felt right to be a slow day – don’t know why, but it did. So a TV favourite film was chosen. Cups of tea and plates of biscuits were in demand, so it felt as though the tea trolley never stopped all day.

Wednesday was Christmas Tree decorating around the home. Clare, Zoe and John worked with many of the residents to dress the trees, with carols playing in the background. A festive tipple of whatever was fancied was also walked round the home to celebrate the decorations. Decorating, colour, laughter and carols continued for the rest of the week, growing ever more colourful and even louder! Thursday saw the Christmas jumpers starting to come out, with even more decorations being designed and created. On Friday, the Christmas jumpers seemed to have multiplied overnight and they were everywhere. A wonderful selection of designs and all worn to raise funds for Save the Children. I do wonder if there is a market for Christmas T-shirts instead of jumpers – by the end of the day, everyone was boiled.

During the day, Di, Margaret Laflin had organised as surprise delivery by Jackie, Hugh’s niece. Di had made a mini-wreath for each and every resident to go onto their room doors. Each was beautiful and unique and walking around the home, they really brought a warm and homely feel to the place. A festive thank-you to you Di, from us all.

And then to close the week, we went back to the Friday afternoon favourite of hot chocolate and whipped cream topped with mini marshmallows. Some residents shared this in the lounge, while others sipped snugly in their rooms – all we need now is some snow.

Now an update on Lateral Flow test, visiting plans and vaccinations, with thanks to the Wiltshire Care Partnership and Wiltshire Council for much of the content.

Wiltshire care homes have continued to perform well but as the infection rate has increased in the community so has the risk with increased infection finding its way into care settings. That is why it is so important that we all take responsibility for reducing the onward transfer of the virus in the community by following the national guidance on Infection Prevention and Control. There have been a small number of isolated but significant outbreaks in the north of the county, especially in Chippenham. Last week, one home in Chippenham had 27 positive cases of COVID amongst both residents and staff.  Local Public Health have been absolutely clear that their investigation and monitoring of these events shows that the homes had done everything in their power to prevent and control infections but as a Public Health expert said recently, ‘this bug really likes humans’!

We have already discussed the much-heralded arrival of Lateral Flow tests. Since the early announcements more information has been received both from the manufacturers and Public Health.

Some of the Limitations of the Procedures from the manufacturers state:

  • ‘1) Clinical performance was evaluated with frozen samples, and test performance may be different with fresh samples.’ [So, they don’t know how it performs on fresh samples]
  • ’14) The performance of this test has not been evaluated for use in patients without signs and symptoms of respiratory infection and performance may differ in asymptomatic individuals.’ [So, they don’t know how it performs with people who are asymptomatic which is what the government guidance is recommending its use for and is the fundamental point of testing visitors at the door for immediate visit pending result].

In addition to this, studies coming out from the north of England regions do not look positive with some agencies identifying only a 50% accuracy level.  Therefore, from a risk assessment and mitigation perspective this is not a test that makes in-room or direct contact even with correct PPE sufficiently safe. Therefore, now is not the time to become complacent and we will not change our current position on visitors.

Once the Lateral Flow tests do arrive and the Home is fully resourced and trained, we will ask all visitors to take the simple test. In theory, these tests should offer additional protection for our residents and staff (and also our visitors), which is always a good thing. However, can all visitors please remember, a 50% accuracy level means that there is a chance that every other test is wrong.

The Lateral Flow tests will also be introduced as an additional test to both our resident and staff testing regime. We will continue with the existing PCR tests; weekly for staff and 4-weekly for residents. The LF tests will provide an additional layer of testing; weekly for staff and fortnightly for residents. Between the two test types, staff will be tested twice weekly and residents every two weeks. Please note that the Public Health advice provided is should a positive LF test result be produced, a further original PCR test will be required to confirm. I think this once again demonstrates the limitations of the test that we have already discussed.

We are sorry that these tests have not delivered the visiting freedom that we had all hoped for, but I am sure, with the detailed explanations above, you will appreciate why we are not taking risks for either our residents, staff or visitors.

The news on vaccinations is more positive. The Pfizer vaccine has arrived and hospitals around the region are starting to deliver these to nursing and care staff. We have prepared our paperwork and are waiting to be called. Currently, Homes with more than 50 residents are being prioritised for both staff and residents. As I mentioned last week, it is unclear whether this vaccine will really be rolled out into Care Homes due to its temperature instability. As always, we will keep you informed. However, we also have the Oxford vaccine coming over the horizon and during the weekend, the BBC was speculating that it may be approved and available before the end of December. This vaccine can be delivered on site without specialist requirements and it is also suggested that it may be more effective in halting transference as well as symptoms.

I am sorry that we have had to go into so much detail on the clinical background, but Lynne, Judith and I felt that it was important that we openly shared with you the rationale behind our decisions.

Have a wonderful week and with the increasing rates around the country, keep safe.