Admissions Policy

Mountside Care Home

Admissions Policy

This policy will be updated in accordance with the risk posed by COVID-19 changes.

Admission and isolation of residents

The safety of Mountside residents and staff is a priority. This section explains what to do when new residents are admitted to Mountside. It also explains what to do when residents are discharged to Mountside from hospital or another care facility and sets out isolation requirements.

Newly admitted residents to Mountside who are transferring from an interim care facility or transferring from another care home will no longer need to self-isolate upon arrival if the below requirements are satisfied:

  • the person admitted is fully vaccinated, wherever possible
  • local guidance from the director of public health about community transmission of variants of concern is followed
  • the person admitted has no known contact with a COVID-positive person
  • Mountside has taken into account the circumstances at the care home or interim care facility from which they are transferring, prior to admission
  • the person is subject to an enhanced testing regime consisting of a PCR test before admission (within 72 hours), a PCR test on the day of admission (day 0) and a further PCR test 7 days following admission (day 7). Additionally, daily rapid lateral flow testing is recommended until the day 7 PCR result has been received

Mountside residents returning from hospital following an overnight stay for elective (planned) care will also not be asked to self-isolate provided the following criteria are satisfied and they should avoid contact with highly vulnerable residents:

  • the person admitted is fully vaccinated, wherever possible
  • local guidance from the director of public health about community transmission of variants of concern is followed
  • the person admitted has no known contact with a COVID-positive person
  • the person receives a negative PCR test result following their return to the Mountside

Mountside residents discharged from hospital following an admission for emergency care should self-isolate, upon arrival, for 14 days, within their own room.

If a Mountside resident tests positive for COVID-19 prior to their transfer, the resident should be discharged to a designated setting. See the government guidance on discharge into care homes: designated settings. When self-isolation is required, a 14-day self-isolation period is recommended for all care home residents because they are particularly vulnerable to COVID-19.

New residents admitted from the community do not need to self-isolate if they satisfy the requirements set out in section 1.4.

If a resident is being admitted from another care home or care facility, the Mountside management will undertake a risk assessment. This will consider the need for a period of self-isolation, bearing in mind any monitored self-isolation undertaken prior to admission. Regard will also be given to the ethical framework for adult social care, and the wellbeing duty in section 1 of the Care Act 2014, and all decisions will be taken in light of general legal obligations, such as those under the Equality Act 2010 and Human Rights Act 1998, as applicable.

This risk assessment will consider, among other things:

  • levels of transmission in the community within which the previous care home or care facility is situated
  • the COVID-19 management of the previous care home or care facility

During their 14-day self-isolation period, all residents (who both are well enough and wish to) will still be supported to leave their room to go outdoors in the Mountside grounds, without restarting their isolation period. This is subject to carefully considered risk assessments that take into account the safety of the resident and other residents within Mountside. Mountside will take steps to mitigate risks, for example, by having staff accompany residents when they go outdoors. Residents who are symptomatic or have tested positive for COVID-19 should not go outdoors.

COVID-19 positive people will not be admitted into Mountside. Where it is not possible to admit a person to a designated setting and there are exceptional circumstances that mean it is unsafe for them to be cared for in their own home until they have completed isolation, the local authority and local NHS trust should agree a risk assessed plan for their care during their isolation period. Designated settings meet a set of agreed standards to provide safe care for COVID-19 positive residents.

No care home should be forced to admit a new resident to the care home if they cannot safely care for the resident, in self-isolation, for the full isolation period. If Mountside is unable to do so, management will ask the resident’s local authority to secure appropriate alternative accommodation.

Visiting during a resident’s self-isolation period: essential care givers

When a resident is newly admitted into Mountside, we will enable visits from the resident’s essential care giver at all times, including during the 14-day period of self-isolation (but not when the Mountside resident or essential care giver has tested positive for COVID-19). Essential care givers are loved ones who provide a greater degree of personal care or support, to maintain a resident’s immediate health and wellbeing. They may help the resident to settle into their new environment.

Mountside will undertake an assessment of each resident, including those newly admitted to the care home, to ensure all residents are able to nominate an essential care giver if they wish to.

Further information on essential care givers can be found in section 2.2 in the guidance for visiting arrangements in care homes.

Admission of residents with a negative COVID-19 test from hospital or care facilities

All hospitalised Mountside residents who have previously tested negative for COVID-19, with a PCR test, should be tested again 48 hours before discharge. The result of this repeat test should be sent to Mountside before re/admission.

When residents are admitted from other care facilities, Mountside will find out whether the person has had a COVID-19 test during the 48 hours before admission and what the result is. If the person has not been tested during this time, Mountside will decide when to test them, using a PCR test and following the care home testing guidance.

Mountside management will receive the COVID-19 test results of anyone admitted to Mountside from hospital, or another social care facility.

Admission of residents with a COVID-19 positive test from hospital or care facilities

All people being discharged from hospitals into Mountside should undergo a PCR test 48 hours prior to discharge, to receive their PCR test result within 48 hours prior to discharge. An exception to this process is for individuals who have previously tested positive for COVID-19 and are within 90 days of their initial illness onset or positive test date. If these individuals have already completed their 14-day isolation period from onset of symptoms or positive test result (if asymptomatic) and have no new COVID-19 symptoms or exposure, they are not considered to pose an infection risk. They therefore do not have to be re-tested and can move directly to Mountside from hospital. These individuals should undergo a clinical assessment to determine their onward movement and isolation requirements as outlined in the discharge into care homes for people who have tested positive for COVID-19 clarification note.

All individuals who test positive should be discharged to a designated setting in the first instance to see out their 14-day isolation period. The total 14-day isolation period can be shared across the hospital and a designated setting, if IPC practices are not breached.

If residents cannot undergo testing, they should be assumed to be potentially infectious. Their COVID-19 status is unknown, and they should self-isolate as a precaution. As designated settings are only for those who test positive for COVID-19, residents who cannot undergo testing should self-isolate within Mountside.

For further guidance on discharge, please refer to the hospital discharge service: policy and operating model and guidance for stepdown of infection control precautions and discharging COVID-19 patients.

Admission of residents who have tested positive for COVID-19 in the past 90 days and have completed a 14-day isolation period

Anyone who has had a COVID-19 positive PCR test in the past 90 days is not advised to be tested again before being discharged from hospital if they:

  • have a normal immune response
  • have completed their 14-day isolation period following the positive test result

They can be discharged into Mountside without going to a designated setting first if they:

  • meet the clinical improvement criteria included in the stepdown guidance
  • have no new symptoms
  • are considered by a clinician not to be an infection risk

A person can test positive for COVID-19 for up to 90 days after first being infected, even though they might have recovered and might not be infectious to others anymore. This is because PCR tests can sometimes still detect remnants of COVID-19 (SARS-Co-V-2 RNA) in a person’s system.

If a patient develops new COVID-19 symptoms prior to discharge, a clinical assessment should be made to determine subsequent onward movement. Again, please refer to the stepdown guidance for more information.

If a person tested positive for COVID-19 more than 90 days ago, they should be tested again 48 hours prior to discharge. The result of this repeat test should be sent to the care home..

Admission of new residents from the community

Residents will be admitted to Mountside from the community without needing to complete a 14-day self-isolation period, if they satisfy the below requirements:

  • the person admitted is fully vaccinated, plus 2 weeks, wherever possible[
  • local guidance from the director of public health about community transmission of variants of concern is followed
  • the person admitted has no known contact with a COVID-positive person
  • Mountside has taken into account the circumstances at the person’s home, prior to admission
  • the person is subject to an enhanced testing regime consisting of a PCR test before admission (within 72 hours), a PCR test on the day of admission (day 0) and a further PCR test 7 days following admission (day 7). Additionally, daily rapid lateral flow testing is recommended until the day 7 PCR result has been received. If a resident cannot undergo testing, they should be assumed to be potentially infectious. Their COVID-19 status is unknown, and they should self-isolate for 14 days as a precaution.

Before admission to Mountside, management will reassure themselves that the individual has not been in close contact with someone with COVID-19 symptoms during the previous 14 days, nor have they been required to self-isolate by NHS Test and Trace. If a close contact has occurred, admission may be delayed until after the end of the relevant period of self-isolation.[footnote 12]

If the individual has taken a test within 72 hours of planned admission into Mountside, management must share the result with the care home’s named clinical lead.

If a test has not been taken or was taken more than 72 hours before planned admission, the individual should be tested. The Mountside manager is responsible for deciding how to test the individual.

If the test result is positive, the Mountside manager will inform the individual’s GP and then follow the same standard procedures for the admission of residents with COVID-19. This means:

Isolation following close contact

Mountside residents who are fully vaccinated will not need to self-isolate following contact with someone who has tested positive for COVID-19 provided they:

  • have received a negative PCR test
  • undertake daily LFD testing during their contact period (up to 10 days)

During this period, they will:

  • avoid contact with other highly vulnerable residents in Mountside
  • continue to follow all outbreak measures in the event of an outbreak, even where they have tested negative

If they become symptomatic then usual testing and isolation protocols apply until their COVID-19 status is confirmed.

Isolation after international travel

As care homes are high-risk settings, residents are advised to limit international travel to and from amber list countries as much as possible, even if fully vaccinated. If residents do travel to an amber list country, they should isolate for 14 days.