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Chapter 4: Children's Residential Units
Overview
4.1 This chapter is for all providers of children's residential units. Generally, wherever possible, such settings should continue to function during a flu pandemic, as they will usually be the only residence for the children who depend on their services. The risk of infection spreading in these settings will not be much greater than in a large family, and is outweighed by the disruption of a transfer to other accommodation for children and young people who will often already have experienced much disruption in their lives.
4.2 Where a provider of Children's Residential Units is responsible for more than one establishment, it may be possible to limit the spread of infection by moving children so that well children are not accommodated with sick ones. However, this will depend on appropriate infection control and medical advice and require the agreement of the local authority responsible for each individual child's care. In most cases, however, well children will need to stay with sick children. In such circumstances providers of Children's Residential Units, with necessary support from primary care services, will need to take action, wherever possible, to prevent the spread of infection. An issue to be addressed is the administration of antivirals to children who are thought to be ill with pandemic flu.
4.3 During a flu pandemic providers of Children's Residential Units will be expected to have arrangements in place to maintain sufficient levels of staff cover in order to comply with Regulation 13 of the Regulation of Care (Requirements as to Care Services)(Scotland) Regulations 2002 and to meet Standard 7 of the National Care Standards: Care Homes for Children and Young People. Where it is necessary to introduce temporary staff at short notice to cover for exceptional levels of staff absence, it will be important for them to be provided with sufficient guidance and supervision to be effective in their role.
4.4 Providers of Children's Residential Units will need to ensure that, as at any other time, any temporary staff have appropriate Disclosure Scotland checks, and that unsuitable adults do not have access to children in any circumstances. Emergency plans should take account of this.
4.5 It is important that you review regularly the plans that you develop now - we would suggest at least annually, and whenever new guidance is issued. We will inform you, on our website and through LAs, when WHO Phase 4 (see Ch 1 for explanation) is reached, and again at Phase 5. These announcements should prompt you to revise plans and prepare to put them into action. You should not leave this until the last minute as there may be little time between reaching Phase 5 and the pandemic reaching the UK.
Secure Units
4.6 There are particular issues in planning for pandemic flu which affect secure units. It will be necessary to consider issues of security, both in terms of detention and in terms of maintaining any support packages in place for young people. This will require liaison between secure units to retain young people within the secure estate. As far as possible secure units should remain open, reducing contact between children if necessary to aid infection control. Any movement of children between secure units must either be authorised by the Chief Social Work Officer or Ministers (for those sentenced by the courts). The Scottish Executive will issue further guidance to secure units to take forward planning for pandemic flu for secure units.
Advice for providers and registered managers
What you should do now
4.7 Providers, in discussion with their registered managers, need now to begin to plan for continuity of care. Some key activities will include:
A. Preparing emergency plans;
B. Ensuring that you have procedures for keeping up to date lists of contact names, phone numbers and addresses (including mobile numbers and e-mail addresses where possible) for all staff;
C. Putting in place arrangements for the recruitment of temporary staff to cover for unusually high levels of staff absence - you will need to take into account the likelihood of demands from other service providers for the same 'pool' of potential cover staff;
D. Ensuring that policies for applying for medical leave (or for special leave to take care of family members) are in place. Staff should be aware that government advice is that they should not come to work, if they think they are ill, during the pandemic;
E. Ensuring that units will be fully equipped with materials needed to implement infection control measures in time to cope with any imminent pandemic;
F. Familiarising yourself with the procedures to be followed if a child in your care dies;
G. Making plans for supporting a home when a child has died;
H. Making plans for supporting a child or staff member who has been bereaved.
4.8 There are other issues that you may need to consider in your plans so that arrangements are in place before a pandemic begins, such as:
A. Heating of buildings;
B. Maintaining health, safety and hygiene arrangements to a high standard, e.g. cleaning toilets, prompt disposal of waste;
C. Continuity of meals provision;
D. Rapid access to medical help if and when required;
E. Willingness of staff to take on a different role for some or all of the duration of a pandemic, and arrangements for the provision of any necessary additional support and supervision;
F. Desirability/practicality of sharing staff between homes;
G. Options for unqualified volunteers assisting while staff are absent (bearing in mind the need to ensure that no unsuitable person has access to children)
H. Plans for when and how you might isolate a sick child.
4.9 In order to develop the plans set out above, we strongly recommend you familiarise yourselves with relevant information and guidance (see Annex).
What you should do during a pandemic
4.10 You should have checked your plans when informed that WHO phases 4 and 5 had been reached. If you have not done so, you should:
A. Advise staff to read any available NHS information;
B. Ensure that all staff have read, and taken action in response to, infection control guidance, that cleaners are informed of measures that need to be taken, and that all necessary cleaning materials are readily available;
C. Ensure that staff and children are aware of the general background information and guidance such as material in the NHS Scotland leaflet for families available on http://www.show.scot.nhs.uk/sehd/pandemicflu/Pages/PanFluFamLeaflet.htm
4.11 As far as possible providers, with their registered managers, should try to maintain normal routines for the children in their care. Your top priority will be to ensure that infection control is practiced consistently and rigorously throughout all the Children's Residential Units for which you are responsible. You will need to keep up to date with advice from the Chief Medical Officer that you would receive through your local authority.
4.12 You will need to take all reasonable steps to ensure that staff who are ill are positively encouraged not to come to work. You should, as far as possible, provide support to staff who are sick or bereaved, and deal sympathetically with requests for leave to care for sick dependants; and also provide support for children who are bereaved.
4.13 If as a result of the pandemic children have to be moved from their established placement, you must inform the local authority responsible for the child's care.
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