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Behind the scenes as care homes prepare for rapid tests

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Care home managers have explained the lengths they are going to so visits "that mean everything" can take place.

A national programme that supplies rapid tests to homes is designed to enable safer visits.

Lateral flow tests that provide a result in around 30 minutes can be used as part of a range of measures that allow friends and relatives to spend time with loved ones in a controlled fashion.

The tests are designed to be used alongside other infection control procedures. This includes the fact that visitors and residents must wear full PPE.

In the first instance, homes with 50 or more beds are invited to take part in the programme.

Home managers that have received the kits around Middlesbrough and Redcar and Cleveland are carefully following guidance, undertaking training and making changes to their buildings in readiness for introducing the testing.

Two managers, one from a Middlesbrough home and the other from Redcar and Cleveland, have explained how their exceptional staff and the supportive families of residents are helping them to prepare.

St Mary's, Linthorpe

Manager Anthony Dulson feels "lucky" at St Mary's.

He has had support from families throughout the pandemic and is getting set to introduce rapid tests from Monday (December 21) after intense preparation.

"Some families have identified that they don't want to come into the home," he says.

"We probably have around 50% of families who say ‘we're not ready yet, we've got to protect you, we've got to protect the residents - you've done a fantastic job protecting our loved ones, the vaccine is coming', then we've got another 50% saying ‘we're happy to trial, but if you as the care home manager say no, we'll respect that and follow the policy'".

A robust risk assessment has been drawn up and the trial will start after a number of changes.

Anthony is mindful of the additional workload on staff, but insists the home feels supported.

"Middlesbrough Council's commissioning team have been brilliant from day one. The amount of support we've had has been phenomenal. We've only had to pick up the phone. We're not on our own, we've had the council supporting us.

"My staff have been absolutely fantastic too. The staff have been 100% supportive and we've had no sickness. I think that's a massive achievement. They've come in and got on with their jobs and additional tasks. I couldn't wish for a greater team."

Astune Rise, Eston

Like St Mary's, Astune already has a pod that allows some controlled visits.

But a number of changes are being made to allow visits inside the home using the lateral flow tests.

Manager Caroline Bowstead explains how a lounge will be used as the new visiting area.

"The home wasn't purpose built so we didn't have a testing area," she says.

"We've were advised that in-car testing wasn't the way forward. We can't bring people into the front door because we have admin staff and other visitors including doctors and other professionals using that entrance. So we can't have someone who is potentially positive using that access.

"We've decided to use the back of the building where we have a little lobby area."

Caroline has completed the training and received the test kits, but is awaiting the barcodes that allow her to process them. It's hoped the rapid tests will commence in January.

Like managers around the area, she's jumped through lots of hoops to get to this stage.

The complex organisation required provides context to a sometimes simplified explanation of how testing can be used to allow visits.

"We need to have the manpower to do that testing and overseeing the full process. We can't use staff that are already on the floor as they're looking after our residents."

Once up and running, the number of visits will be limited due to the approximate 40-minute test and result window, followed by the visit itself and subsequent deep cleans.

With support from Redcar and Cleveland Council's commissioning team, Caroline and her staff have worked through the various obstacles with the residents and their families in mind.

"Visits are everything to me," she says.

"I've felt like a prison warden since March, keeping people in and keeping people out. I'm so desperate to get it done. I need the residents to be back with their families, but I need it to be safe and I need it to be organised and not to put extra pressure on staffing."

Astune's staff have been "absolutely phenomenal", Caroline adds.

"We haven't had a staff member test positive since May. They've just been amazing."

‘Unsung heroes'

Cllr Dorothy Davison, Executive Member for Adult Social Care and Public Health at Middlesbrough Council, has praised the commitment of care staff across the town.

"Care home staff are the unsung heroes of this crisis," Cllr Davison said.

"Their dedication to residents in their care shines through. I know managers and their teams are taking every possible step to make sure visits can happen in a controlled fashion.

"I'd also like to thank families for their patience and understanding at this time."

Cllr Mary Ovens, Cabinet Member for Adult Services at Redcar and Cleveland Borough Council, said: "Care homes in our area have really gone the extra mile during the pandemic to keep their staff, residents and visitors safe.

"They quickly implemented the latest infection control advice and use of PPE with their focus remaining firmly on the wellbeing of the people in their care.

"The additional coronavirus testing capacity will be delivered in a safe and professional way by the care home staff and help them manage the spread of the virus much more effectively."

Rapid testing can't start or continue in homes experiencing an outbreak among either residents or staff. Homes must dedicate a minimum of two staff to the testing, taking them away from normal duties.

A waiting area, space for putting on and removing PPE and a workstation for processing the tests is also required.