Unique HomeCare Services and Coronavirus (COVID-19)

Reducing the spread of Coronavirus (COVID-19) especially in the high-risk population we service is of vital importance.

Our procedures have always emphasized infection control and prevention to minimize transmission between our clients and staff, including proper hand washing before giving care, using disposal gloves during care, and properly hand washing after giving care.

Per the Massachusetts Department of Public Health and the federal Centers for Disease Control and Prevention (CDC) guidance for Agency Based In-Home Caregivers & Workers, please see the guidance below, we have reviewed our procedures.

During this heightened period of concern we have:

· Employees review of all Unique HomeCare Services procedures.

· Employees review COVID-19 information and updates from the Massachusetts Department of Public Health and the federal Centers for Disease Control and Prevention (CDC) as they are released.

· Plans to address possible workforce shortages.

Please contact Unique HomeCare Services with any questions or concerns.

Agency Based In-Home Caregivers & Workers
(e.g. Home Health Agencies, Personal Care Management Agencies, Home Care Agencies, Adult Foster Care, etc.)
2019 Novel Coronavirus (COVID-19) Guidance

March 2020

This guidance is based on what is currently known about the transmission and severity of 2019 novel Coronavirus Disease (COVID-19). The Massachusetts Department of Public Health is working closely with the federal Centers for Disease Control and Prevention (CDC) to provide updated information about the COVID-19 outbreak. This guidance will be updated as needed and as additional information is available. Please regularly check mass.gov/2019coronavirus for updated interim guidance. Additionally, if you are a CMS-certified agency, please review and stay updated on CMS guidance. Each organization faces specific challenges associated with implementation based on its population, physical space, staffing, etc., and will need to tailor these guidelines accordingly. This guidance is intended to supplement, not supplant, provisions from regulatory agencies that oversee health care organizations. Organizations may develop their own policies, but these policies should be based on current science and facts and they should never compromise a client’s or employee’s health.

Background

What is Coronavirus Disease 2019 (COVID-19) and how does it spread?

· COVID-19 is a respiratory virus. Current symptoms have included mild to severe respiratory illness with fever cough, and difficulty breathing.

· According to CDC, the virus is spread mainly from person-to-person, between people who are in close contact with each other (within about 6 feet).

· Spread is from respiratory droplets produced when an infected person coughs or sneezes.

Who should be most cautious?

· Those considered “high risk” include people over the age of 60, anyone with underlying health conditions or a weakened immune system, and pregnant women.

What should agencies be doing to mitigate the risk of spreading COVID-19?

Screen yourself, staff, vendors, and clients for any of the conditions below:

· Sick with fever (higher than 100.3 o F) or newly developed respiratory illness such as cough, shortness of breath, or sore throat.

· Recent international travel (i.e., within the past 14 days) from COVID-19-affected geographic areas.

· Close contact with a person diagnosed with COVID-19 in the past 14 days

Preparing and Educating Staff:

· During times of COVID-19 circulation in the community, ensure employees are able to stay home if they have symptoms of acute respiratory illness or if they need to care for a sick family member.

· Make sure your employees are aware of these policies. Do not require a healthcare providers’ note to
validate illness or return to work, as healthcare provider offices and medical facilities may be extremely
busy and not able to provide this documentation.

· If employees become ill with respiratory symptoms while at work, they should be sent home as soon as possible.

· Make sure your employees are aware of these policies. Sick persons should cover their noses and mouths with a tissue when coughing or sneezing (or cough into their elbow or shoulder if tissues are not available) and perform hand hygiene immediately after.

· Those with symptoms of acute respiratory illness should stay home and not return to work until they are free of fever (oral thermometer temperature of less than 100.3 degrees) and any other symptoms for at least 24 hours, without use of fever-reducing or other symptom altering medicines (e.g. cough suppressants).

· If an employee is diagnosed with COVID-19 they cannot return to work until they have been authorized to leave their home by their local board of health.

Identify ways to limit direct person-to-person contact by leveraging technology, where appropriate.

Provide access to personal protective equipment (PPE), such as facemasks and gloves, as available.

· CDC recommends universal use of Standard Precautions when caring for any client.

· Reinforce the importance of strict adherence to Standard Precautions during all client encounters.

· Standard Precautions are based on the principles that all blood, body fluids, secretions, excretions (except sweat), nonintact skin, and mucous membranes may contain transmissible infectious agents.

· For example, a facemask and eye protection should be worn during the care of any client if splashes, sprays or coughs could occur during the client encounter.

· Similarly, gloves should be worn if contact with body fluids, mucous membranes, or nonintact skin is anticipated.

Avoid unnecessary out of state or international travel and avoid large gatherings or crowds.

· Agency staff, and especially caregivers, provide essential services that help others to function throughout their daily lives. Agency staff health and the health of those you serve is of utmost importance.

· Agencies should set up ways to appropriately limit staff travel and possible exposure.

· Cancel large and do not attend large gatherings of more than 250 people.

Reinforce the practice of good daily hygiene with all staff.

· Wash your hands often with soap and water for at least 20 seconds, especially:

· After going to the bathroom;

· Before eating;

· After blowing your nose, coughing, or sneezing; and

· Upon entering and exiting the client’s home.
· If soap and water are not available, use an alcohol-based hand sanitizer with at least 60% alcohol.

· Cover a cough or sneeze with a tissue and dispose of tissue.

· Don’t touch your eyes, nose or mouth without first carefully washing your hands.

· Properly clean all frequently touched surfaces on a regular basis using everyday cleaning products.

· Avoid sharing dishes, drinking glasses, eating utensils, or towels.

· Wash dirty dishes in a dishwasher or, if by hand, with warm water and soap.

· Laundry can be washed in a standard washing machine with warm water. It is not necessary to separate laundry used by a client from other household laundry.

· In order to avoid germs, do not shake dirty laundry or “hug” dirty laundry to your chest to carry it.  Monitor staff emotional health.

· Emotional reactions to stressful situations such as new viruses are expected. Remind staff that feeling sad, anxious, overwhelmed, or having trouble sleeping or other symptoms of distress is normal.

· If symptoms become worse, last longer than a month, or if they struggle to participate in their usual daily activities, have them reach out for support and help.

Monitor staff emotional health.

· Emotional reactions to stressful situations such as new viruses are expected. Remind staff that feeling sad, anxious, overwhelmed, or having trouble sleeping or other symptoms of distress is normal.

· If symptoms become worse, last longer than a month, or if they struggle to participate in their usual daily activities, have them reach out for support and help.

· If one is available, encourage employees to call their Employee Assistance Program. The National Disaster Distress Helpline is available with 24/7 emotional support and crisis counseling for anyone experiencing distress or other mental health concerns. Calls (1-800-985-5990) and texts (text TalkWithUs to 66746) are answered by trained counselors who will listen to your concerns, explore coping and other available supports, and offer referrals to community resources for follow-up care and support.

Complete the Coronavirus COVID-19 In-Home Care Agency Checklist Tool on pages 4-8.

Organizational Preparedness. These preparedness steps may help protect your agency while minimizing disruption to your important services.

· Develop or review business continuity plans for how to keep critical services going if staffing levels drop due to illness or taking care of ill family members or children that may be temporarily out of child care or school settings.

· Be prepared to change your practices as needed to maintain critical operations (e.g., prioritize clients or temporarily suspend some services, if needed).

· You may also wish to refer to CDC: Interim Guidance for Businesses and Employers to Plan and
Respond to Coronavirus Disease 2019 (COVID-19)

· Cross-train personnel to perform essential functions so the site can operate even if key staff are absent.

· Assure you have adequate supplies of soap, paper towels, tissues, hand sanitizers, cleaning supplies, and garbage bags. If possible, a supply of disposable gloves and paper facemasks will be useful if persons become ill while at your program site.

Steps to follow if staff, or someone they know or care for is sick:

If staff are sick:

· They should stay home and not come to work. Do not schedule them to work if they are sick.

· Follow the steps outlined on page 9.

Follow the flow chart on page 9 to determine the best care path for an individual for whom your agency provides care and who is diagnosed with COVID-19 or is experiencing symptoms.

If you have staff that live with a sick individual some general guidance to share with them includes:

· Keeping the sick person in a separate, well-ventilated room and apart from other people and pets as much as possible.

· If a separate space is not available, keeping a distance of at least six feet from people who are well.

· A sick person who is coughing or sneezing should wear a mask when around other people. If the sick
person cannot wear a mask, the caregiver should wear a mask. The bathroom should be cleaned every day using a household disinfectant according to the directions on the label. Wear gloves while cleaning.

· Providing the sick person with a separate bathroom if available and a trash bag within reach.

· Limiting activities outside the home until the sick person is feeling well for at least one day.

· Limiting outside visitors.

Coronavirus COVID-19 In-Home Care Agency Checklist Tool (Page 1 of 4)

1. Review your Emergency Plan/Continuity of Operations Plan.
2. Update your Plan to reflect changes based on your review and current situation.
3. Update all workforce contact information.
4. Coordinate with local emergency operations/ local health department/health care coalition
5. Review personnel policies with regard to use of personal time, sick time, overtime. Develop
contingency policies.
6. Check with your vendors about supply chain especially those that provide you with medications for your clients.
7. Plan to address workforce shortages. Contract with other agencies for additional workforce.
8. Develop a plan to cross train workforce wherever possible.
9. Develop a questionnaire to identify which workforce members are available to work extra and flexible hours. Also identify workforce members that may be employed by another health care provider as they may have a commitment to that organization in an emergent situation.
10. Communicate your plan with partner agencies.
11. Help your workforce develop a plan for their families.

CLIENT CARE

1. Assess your Client Classification Levels for possible triage and keep hard copy easily accessible. Do this on a regular basis while we are in this current situation.
2. Identify client family members who may be able to take on more care responsibility if necessary.
3. Develop a Back Up Care Plan.
a. List names and responsibilities.
b. Get governing authority approval.
4. Begin to develop plans for possible surge capacity based on staffing and client classification levels. This means forecasting with a possible significantly reduced workforce.
5. Develop alternate staffing patterns such as longer days.
6. Ask screening questions before each visit and identify responsible person for conducting screening (scheduler, supervisor, worker, etc.).

SITUATIONAL AWARENESS

1. Communicate with local emergency preparedness organizations.
2. Assign one person to monitor daily updates from CDC, DPH, and World Health Organization.
3. Be aware of state updates, resources and communications.

INFECTION CONTROL AND PREVENTION

1. Educate/re-educate workforce in the following:
a. Standard Precaution
b. Transmission- based precautions such as
1) contact
2) droplet
2. Review Nursing Bag Technique with all field personnel.
3. Download multi-lingual client seasonal influenza information and distribute to clients and
their family members.
4. Re-educate workforce on handwashing protocols using running water and waterless hand
sanitizers.
5. Offer seasonal influenza vaccination to workforce and clients.
6. Check PPE supplies and dates. Move outdated to back and label as outdated but do not discard at this time.
7. Educate workforce again in donning and doffing of PPE and in sequential order.
8. Review your infection control policies for surveillance, recognition, identification and reporting requirements for workforce and clients.
9. Have a process to monitor and report any workforce or client illnesses in your organization.
10. Develop an occupational health plan and policies for any workforce members with an exposure to COVID-19.

About Unique HomeCare Services

Unique HomeCare Services provides private in-home care for elders, those with Alzheimer’s or Dementia, and people who are recuperating from illness, injury, or surgery.

We provide both short-term and long-term in-home care needs from as little as one 4 hour day a week to 24 Hour Care and Live-In Care.

We offer a full range of in-home personal care services including Bathing, Personal Hygiene and Grooming, Dressing Assistance, Toileting and Incontinence, Feeding, and Medication Reminders.

We also provide support services such as Case Management, Accompaniment to Appointments, Nutrition and Meal Management, Light Housekeeping and Laundry Services, Bed and Wheel Chair Transfers, and Shopping and Running Errands.

Unique HomeCare Services is headquartered in Norwood, Massachusetts and serves the surrounding communities.

It is our pleasure to assist our veteran clients with VA Aid and Attendance Benefit approval at no cost.

We have an extensive Directory of Online Senior and Caregiver Resources for the information you need.

To schedule a no cost and no obligation In-Home Assessment to determine the home care needs and get a quote, please call us to speak to a Case Manager at (800) 296-9962 or fill out our Free Quote Contact Form.