Councils asked to identify ‘designated facilities’ for discharged patients

Local authorities have been asked to urgently identify “designated facilities” to manage any rapid discharge of hospital patients into care homes during a second wave of coronavirus.

A letter to the directors of adult services from the Department of Health and Social Care (DHSC) says patients with positive Covid-19 tests must be discharged into an “appropriate designated setting”.

These must be inspected by the Care Quality Commission (CQC) to ensure they meet the regulator’s infection control standards.

It says anyone discharged into a care home must have a test result which is communicated in advance to the residence.

Councils will be required to provide alternative accommodation for the resident to isolate in if a care home does not have appropriate facilities.

They have been asked to identify accommodation that could meet current and future winter demand and notify the CQC of these premises, “ideally” by Friday or as soon as possible.

According to the letter, the CQC is ready to approve 500 settings by the end of November, and will prioritise areas with the highest level of restrictions.

The DHSC letter said it is hoped that every local authority will have access to at least one CQC designated site by the end of October.

The cost of these designated facilities is expected to be funded through the £588 million discharge funding.

The letter, from the DHSC’s director for Adult Social Care Quality, Tom Surrey, reads: “Emphasis should be on commissioning standalone units or settings with separate zoned accommodation and staffing.”

The designated scheme does not apply to residents who contract Covid-19 in their care home, people using emergency departments who are not admitted, or people supported to live in their own home, it adds.

Local authorities have also been asked to ensure there is repeat testing, sufficient personal protective equipment (PPE), arrangements for staff isolation or non-movement, protection from viral overload, sickness pay and clinical treatment.

On Tuesday, the joint Commons inquiry into the pandemic heard that the country cannot “predicate everything on intensive care units and acute beds not being overwhelmed” going into winter.

Professor David Oliver, geriatric consultant at the Royal Berkshire NHS Foundation Trust, said of the first wave: “‘Protect the NHS’ essentially meant ‘protect the acute hospital bed bays’, with everything else a bit of an afterthought, which is a mistake.”

The committee also heard from a care home manager who said they were “kept blind” by hospitals not communicating key information on patients to be discharged.