Health of staff and service users
In this section:
- special consideration for people at high clinical risk
- Test, Trace, Isolate and Support
- outbreak management
- contact tracing
- learning groups
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 Test and Protect COVID-19 guidance which says people with symptoms should stay at home and self-isolate for 10 days
Shielding was paused on 1 August. Since then we have been advising those who are at highest risk should they contract coronavirus, including those who were formerly asked to shield, to follow the same guidance as the rest of the population stringently and with extra care. The best protection for people who are most at risk from the virus is to stop its spread in our communities. Building on the support we put in place at the start of the pandemic, we are providing the information, advice and tools people need to make choices about their day-to-day activities and interactions, including work.
The majority of workplaces can be made safe. We are not advising people to stop going into work if you cannot work from home, but advise them to ask their employer to use the workplace risk assessment tool found at www.mygov.scot/shielding to support discussions with their employer so that the necessary adjustments to their workplace can be made. If their workplace cannot be made safe, at Levels 2 and 3, we are suggesting they can discuss whether they need a fit note with their GP or consultant.
At Level 4, the Chief Medical Officer will issue a letter to people on the shielding list which is similar to a fit note and which will last for as long as the individual’s area is under Level 4 restrictions. This letter can be used in the few cases where it is not possible to make their workplace safe. This does not automatically mean they should not attend work.
We are also asking people on the shielding list to sign up to our text message service to get updates to your mobile. To sign up they need to send their Community Health Index (CHI) number to 0786 006 4525.
As the Test and Protect approach continues, all workers should follow health protection advice to isolate either themselves. If someone develops the symptoms of COVID-19, such as a high temperature, a new, continuous cough or a loss/change to your sense of taste or smell, everyone within the household should self-isolate and not attend their place of work. Individual health factors should be taken into consideration when CLD staff and volunteers are able to return to face to face engagement as restrictions ease.
Organisations should suspect an outbreak if there is either:
- two or more linked cases (confirmed or suspected) of COVID-19 in a setting within 10 days - where cross transmission has been identified
- 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 and 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. A close contact should self-isolate for 10 days. 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 reason
The Health Protection Team or Incident Management Team will declare when the outbreak is over.
Read guidance for employers. 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.
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, they must self-isolate for 10 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.
For Test and Protect and contact tracing purposes, a ‘household contact’ is defined as:
- those who are living in the same household as a case (e.g. those that live and sleep in the same home, or in shared accommodation such as accommodation that share a kitchen or bathroom.
- those who do not live with the case but have contact within the household setting: those that have spent a significant time in the home (cumulatively equivalent to an overnight stay and without social distancing e.g. 8 hours or more) with a case
- sexual contacts who do not usually live with the case
- cleaners (without protective equipment) of household settings during the infectious period, even if the case was not present at the time.
CLD services must ensure that contact details for staff and learners are up-to-date, and that staff and learners are aware of their responsibility to alert the service to any changes throughout the year.
CLD services should keep records of staff and learners who have attended activities. Records should also be kept of visitors and contractors. Particular attention should be made to the guidance on lawful data collection and management.
Where face-to-face learning or activities are delivered, CLD services should ensure that appropriate mitigating measures are put in place, e.g., physical distancing. Guidance about the maximum size of gatherings allowed in wider society in Scotland (e.g. places of worship) may provide a suitable benchmark for the advisable maximum size of a single group activity.
Where possible, activity groups should be consistent throughout the day to reduce the risk of transmission. CLD services should consider the most appropriate delivery and timetabling models to keep mixing of groups to the minimum necessary while ensuring a full range of services can be offered.
In smaller acvtivity settings, where shared resources might normally be used, physical distancing measures must be in place. Sharing of resources must be kept to a minimum as far as possible. If unavoidable, resources and the surrounding area should be sanitised between use, and learners should ensure the previous user has cleared the area before proceeding with use.
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