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Discharging Covid-positive patients from hospital to care homes

Scientific data shows a decline in the rate of transmission of Covid in most parts of the country since the start of the roll-out of the UK vaccination programme. An ongoing focus in protecting the community aims to keep the rate of transmission low. Patients in hospital with a Covid-positive result must be discharged into the community safely.

The Department for Health and Social Care (“DHSC”), supported by CQC, local authorities and care providers, is leading an initiative to provide assurance of safe and high-quality care in designated settings. The designated settings are specifically to provide a place to enable an interim period of isolation for people who are discharged from hospital with a Covid-positive test who will be moving to or going back into a care home setting. This initiative is intended to help prevent the further spread of coronavirus in care homes and will also allow for the appropriate level of care to be given to those in need.

The aim of the initiative is for each local authority to have access to at least one designated setting. CQC is working closely with the DHSC to ensure social care designated settings are appropriate. When CQC inspects designated settings, the following checks are made to ensure infection control is maintained:

  • Are services physically separating the group of residents?
  • Is a dedicated workforce in place?
  • Is there appropriate ventilation?

Designated settings will be inspected using the Infection Prevention and Control (“IPC”) framework. When reporting on designated settings to the public, the following information will be provided:

  • The provision of PPE for staff and residents to control infection safely
  • Staff training and procedures to deal with outbreaks
  • Whether shielding and social distancing is complied with
  • Layout of the premises, use of space and hygiene practice to encourage safety.

The process of a location becoming a designated setting:

  • The local authority should identify the premises, in collaboration with the proposed provider.
  • CQC will carry out inspection of the premises against the IPC framework and notify the Director of Adult Social Services as to whether the premises are appropriate.
  • The Director of Adult Social Services should then communicate the results to the relevant provider and confirm whether the setting has passed the assurance. Where assurance has not been met, information will be provided in respect of the changes which need to be made in order to pass assurance.
  • Once a setting has passed assurance, the local Clinical Commissioning Group (“CCG”) will be notified and an agreement will be made between the CCG and the provider as to when the discharge pathway is to be “switched on”. Once a setting is “switched on”, the designated setting will become ready to be used.
  • The Director of Adult Social Services or the CCG should then notify hospitals or the multidisciplinary discharge teams and the Directors of Public health that the designated setting is available for use. This is when the designated setting will be “switched on”.

Updates regarding designated settings in specific regions can be found directly on the CQC website. The Government has also published guidance relating to the initiative together with information on the requirements that need to be met.




This briefing is for guidance purposes only. RadcliffesLeBrasseur LLP accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.

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