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Easing restrictions in Shared Lives and respite after notice to isolate

As of 19 July, England has moved on to the final phase – step 4 – of the government’s “roadmap” out of lockdown, and most of the restrictions in place to tackle the Covid-19 pandemic have lifted. In Scotland, government have moved to “level 0,” and in Wales, restrictions are at “level 1” with the move to “level 0” slated for August 7. We have been thinking about what people in Shared Lives can do to try to get on with life as safely as possible and in a way that upholds people’s rights. There is, at the time of writing, no government guidance for the social care sector specifically.

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While many of us will be looking forward to a return to a life more as it was before the pandemic, many will be concerned about “opening up,” especially those people who are clinically vulnerable. The government itself has advised caution, and cases of Covid-19 are still very high.

To that end we encourage everyone – Shared Lives scheme workers, carers, and those being supported, to continue to follow government guidance to stop the spread of Covid-19 and on protecting people defined as extremely vulnerable (updated as of July 19.) In particular we encourage you to:

  • Continue to wash hands regularly,
  • Get tested if you have symptoms,
  • Where possible, meet outdoors and let fresh air into homes and other enclosed spaces.
  • Continue to wear a mask in enclosed and crowded spaces such as public transport and public places/venues.
  • Get both doses of vaccine as soon as you are able

Respite arrangements when Shared Lives carers are notified by track and trace

As of July 19, double vaccinated frontline NHS and social care staff in England who have been told to self-isolate will be permitted to continue to work in exceptional circumstances and after having a negative PCR test followed by daily negative lateral flow tests for a minimum of seven days. The exceptional circumstances are where staff absence may lead to a significant risk of harm.

Earlier in the year we already received clarification from a contact at CQC that Shared Lives carers who support people who live permanently with them in live-in arrangements, do not necessarily have to stop providing care in the event of a notification to isolate from the NHS or even a positive Covid test.

We recognise that not being able to undertake a respite break could cause a serious risk of harm. However, we encourage schemes to explore all other options before going ahead with a planned respite stay with a Shared Lives carer who has been told to isolate. For example, arranging the break with another Shared Lives carer. Where all other options have been exhausted, the Shared Lives scheme should weigh up the risks of not having the break, against the possible risk of infection with Covid-19.

The person being supported in Shared Lives should be given information about the risks in a way that they can understand, and their wishes must be taken into account. If they lack capacity to make an informed choice about these risks, then a decision must be taken in their best interest. Ultimately, where this situation occurs, the decision must rest with the Shared Lives scheme.

The latest change means that planned respite arrangement can now go ahead even if the Shared Lives carer scheduled to provide the respite break has been notified by Test and Trace to isolate, if their absence could lead to “serious risk of harm,” providing:

  • The person they support wishes to continue with the break (and has capacity to make that decision) or it is clearly in their best interests to do so, in the absence of viable alternatives
  • They continue to self-isolate as a close contact when not at work
  • They are fully vaccinated, with 14 days having elapsed since their final dose
  • They isolate initially until they have taken a PCR test and received a negative result
  • They undertake daily lateral flow tests and report the results to Test and Trace and their scheme worker. They should not attend work if they receive a positive result and should then arrange a PCR test as soon as possible.
  • They stay at home and arrange an immediate PCR test should they develop symptoms
  • They comply with all relevant infection control precautions and wear PPE
  • They support someone who is not classed as clinically extremely vulnerable
  • They stay in regular contact with their scheme worker to inform them of their test results.