Health of staff and service users
The virus is expected to remain in the population for some time even after lockdown restrictions have been eased. As part of risk assessments employers should explore how to respond should anyone develop symptoms while at work, including whether it is possible to identify parts of the site the individual may have accessed or equipment used while symptomatic.
CLD providers, staff, volunteers and learners have a responsibility to ensure they adhere to the Scottish Government Test and Protect COVID-19 guidance which says people with symptoms should stay at home and self-isolate.
Protecting people who are higher risk
The shielding category consists of those who have been identified as being at the highest risk from severe illness from Covid-19. Individuals in the shielding category have been advised not to work outside the home, and this will continue until such times as the general advice to shield is paused. See NHS Inform for further information. People who live with someone who is shielding are not advised to stay away from work; however, they should be supported to stringently follow physical distancing guidance.
Those identified as being at increased risk from Covid-19 are those following physical distancing advice more stringently. As they are at higher risk of severe illness (for example, people with some pre-existing conditions) they have been asked to take extra care in observing physical (social) distancing. People who live with someone who is at increased risk are not advised to stay away from work, but as above, should be supported to stringently follow physical distancing guidance.
Workers who are shielding should not be compelled to attend work outside the home for as long as the shielding advice is in place. If workers who are shielded cannot work from home, companies should make arrangements to ensure those staff are not disadvantaged due to obeying medical advice. Companies should explore measures such as suspending the normal application of sickness or disciplinary procedures related to attendance in these cases.
The shielding advice is in place until at least 31 July. If the shielding advice is paused after this, then those who were shielding would be categorised as at increased risk and should follow physical distancing measures more stringently than the general population, and be risk assessed to ensure they can do this. The default position should remain that wherever possible, people should work from home and should only return to the workplace where they can do so safely.
If those at increased risk (but not in the shielding category) individuals cannot work from home, they should be offered the option of the safest available on-site roles, enabling them to maintain physical distancing. Workplace activities should be carefully assessed to identify if they involve an unacceptable level of risk.
Organisations should suspect an outbreak if there is either:
- Two or more linked cases (confirmed or suspected) of COVID-19 in a setting within 14 days - where cross transmission has been identified; or
- An increase in staff absence rates, in a setting, due to suspected or confirmed cases of COVID-19.
If an organisation suspects a COVID-19 outbreak, they should immediately inform their local NHS board Health Protection Team (HPT). The organisation may be then contacted by them, as they may get information from NHS Test & Protect or other sources.
In the event of an outbreak:
- Continue to follow 'General Guidelines' to reduce risk, as detailed above
- The local Health Protection Team will undertake a risk assessment and conduct a rapid investigation. They will advise on the most appropriate action to take
- Staff who have had close contact with case(s) will be asked to self-isolate at home. In some cases, a larger number of other staff may be asked to self-isolate at home as a precautionary measure. Where settings are observing guidance on infection prevention and control, which will reduce risk of transmission, the local health protection team will take this into account in determining whether closure of the whole setting will be necessary
- Depending on the risk assessment outcome, the Health Protection Team may establish an Incident Management Team (IMT) to help manage the situation
- The Incident Management Team will lead the Public Health response and investigations, and work with the organisation to put appropriate interventions in place
- To control an outbreak the Health Protection Team and Incident Management Team will work with the organisation to put appropriate interventions in place. These will generally include ensuring that the preventive measures described in 'General guidelines to prevent spread of COVID-19' (detailed above) are fully implemented.
Other measures may include:
- Cleaning in the setting: for cleaning and waste management, refer to guidance on cleaning in non-healthcare settings for maintaining hygiene.
- Consider wider testing of affected population and staff:
- Information: ensure that staff (and other relevant people) are aware of what has happened and the actions being taken.
- Closure: may be done following advice from the Health Protection Team and Incident Management Team or the business may make their own decision on closure ahead of this advice as a precaution or for business continuity reasons
The Health Protection Team or Incident Management Team will declare when the outbreak is over.
Appropriate public health advice in supporting staff and volunteers who are shielding and clinically vulnerable should be followed at all times. This advice will adjust accordingly if new public health advice emerges.
Test and Protect
In line with Test and Protect everyone should follow the NHS Inform guidance on self-isolation if they or anyone in their household shows coronavirus symptoms.
Individual health factors should be taken into consideration when CLD staff and volunteers return to face to face engagement in Phase 3 and beyond.
Guidance for employers can be found on the Scottish Government website. Employers are asked to support CLD staff in ensuring the spread of the virus is contained by supporting employees to stay at home where required. Staff should not be asked to return to work under any circumstances before the end of the isolation period. See a useful infographic produced by COSLA.
People who have tested positive for the virus will need to self-isolate. NHS contact tracers will interview them and get in touch with people they have been in close contact with, and tell those in close contact that they must self-isolate for 14 days. If CLD staff, volunteers or learners are informed by a contact tracer that they should isolate, they should be supported to do this straight away.
A close contact is defined as:
- those that are living in the same household as a case
- face to face contact with a case for any length of time within 1 metre of a case
- extended close contact within 2 metres for more than 15 minutes with a case.
Where Infection Prevention Control measures have been utilised such as protective screen or use of PPE the contact tracer will conduct a risk assessment to identify contacts at risk. The priority is to public health in order to break the chain of transmission of COVID-19. Advice for employers on helping staff who need to self-isolate
Planning should recognise that ongoing physical distancing measures required to reduce the spread of the virus may mean that the number of employees able to be accommodated safely in the workplace is limited. The workforce may have questions or concerns about returning to work. Companies are encouraged to work with trade union or workforce representatives to enable individuals to work from home while self-isolating, if appropriate. If able to work from home, employees should continue to do so after a period of self-isolation has ended.
Pay for CLD staff who are sheltering, self-isolating, sick or balancing care responsibilities is likely to be a source of concern for employees. CLD providers should work with trade unions or workforce representatives to provide early guidance to workforces on processes and support for individuals affected by these issues. Again opportunities to facilitate home working where feasible should be actively pursued and maintained.
Workers who are shielding or who live with someone who is shielding, should not be compelled to attend work and CLD providers should make arrangements to ensure those staff are not disadvantaged due to obeying medical advice. CLD providers should explore measures such as suspending the normal application of sickness or disciplinary procedures related to attendance in these cases.
Organisations providing CLD services should also acknowledge the range of factors likely to cause stress or anxiety amongst employees, ranging from living with lockdown arrangements to concerns about travel, schools, caring responsibilities and relatives impacted by the virus, amongst others. This may have implications for mental health with managers encouraged to be conscious of how these factors may impact on the well-being of individual staff members. Companies and trade union or workforce representatives should be alert to this and direct anyone experiencing mental health issues towards available support.
If you would like to provide feedback or have any questions related to this guidance please email Elisha.Fisher@gov.scot