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Consultant Geriatrician Dr Gerry's statement on COVID-19 - 27 May 2020

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Thank you for inviting me today to talk about the actions we have taken to help care homes on the Isle of Man cope in the face of COVID-19.

We realised early on that COVID-19 posed a significant risk to the integrity of the health and social care services on the Isle of Man and that it posed a particular risk to the frail and elderly residents of our Island.

COVID-19 poses a particular risk to the care homes here and abroad given the community of residents and the carers living in close proximity. Our aims were to increase the resilience of these care homes with the hope to reduce the transmission of COVID-19 to care home staff and other residents and have plans in place should another outbreak occur. The best way to care for everyone is to care for the carers.

The journey has been a very collaborative one with a multidisciplinary team spanning the acute and community settings. Having only been on the island a few months it has been my pleasure to meet and work with my GP colleagues, the senior nurses and infection control and the caring staff of numerous care homes.

Planning to minimise risk has come to a three part process, firstly an assessment of current preparedness with guidance and advice on improvements in the now, an ongoing support and assurance process and finally an ‘outbreak’ team to rapidly assess and respond to a new positive test in a care home.

The first step, of assessing and supporting preparedness has involved infection control, senior nursing, care home managers and staff, general practice and hospital consultants. We assess the policies and processes to do with infection control and PPE, education and training, environment and an assessment of particular challenges for and posed by residents. From this we generate a matrix with a red, amber and green rating and this rating informs the ongoing support we offer. This process has been invaluable in terms of learning for both the community and us with each visit giving a layer of detail that the next home benefits from. The outcomes are discussed as a multidisciplinary team each week.

We have defined an outbreak as one new positive test in either a carer or resident of a care home and we have responded on two occasions. The outbreak response team is similar to the initial assessments with community and acute colleagues, nursing, medical and care home staff. The team meet either the same day or then next morning at the care home to assess PPE stocks, use and environment. All residents are also reviewed to individually assess their care and organise immediate actions required for care.

The assessments have all been done with consent and are intended as a support, not only the mechanics of managing infection but also in the emotional support for all colleagues across health and social care. COVID-19 is scary but managing together is less so.

Thank you.