Public Health County Hall Martineau Lane NR1 2SQ

General Enquiries: 0344 800 8020 Textphone: 0344 800 8011 Fax: 01603 223096

Date: 03 December 2020

Dear Provider,

You will know already that the government plans on implementing rapid ‘lateral flow’ testing for care home visitors as part of a plan to support face to face visiting in all tiers. The process of training and supply of test kits has commenced. However, at present the majority of care providers are not in a position to start lateral flow testing. Whilst we are in this interim period, we advise the continued use of current guidance as laid out in this letter.

Our priority remains to keep residents, staff and visitors safe and well.

The decision as to whether to allow visitors, and in what circumstances, remains with the provider of each care provision. However, the guidance from ’s Director of Public Health is that all visits should be carried out under the enhanced restrictions as set out in the summary table below.

Risk level Definition Action National 7 day incidence rate of <100 cases per Current national guidance on care 100,000 and no evidence of high risk local home visiting should be followed outbreak Enhanced Areas in which there is a rapid rise in Enhance precautions for visiting COVID-19 cases or a 7 day incidence rate should be implemented including, of >100/100k and/or on going outbreaks but not limited to; that pose a risk to transmission to the local community i. Visits taking place in designated areas outside of main building with screens in place ii. Window visits iii. Outdoor visits with social distancing iv. Video calls or ‘virtual visits’

Review in 2 weeks

The following areas have been identified as areas of enhanced risk where enhanced precautions should be implemented such as those suggested in the table above (areas not listed below are within the ‘national risk’ category):

Breckland Dereham North & Neatherd

Attleborough

Broadland Alysham Coltishall, Buxton & Frettenham Sprowston East Spixworth & St Faiths Wroxham, Rackheath and the Plumsteads Taverham Sprowston Central Thorpe St Andrew North

Great Yarmouth Caister on Sea Gorleston West Southtown & Cobholm Yarmouth North

King’s Lynn & West Gaywood North Bank Grimston, Gayton & Marshland, Walpole & Walton North Lynn Terrington and Clenchwalton Watlington, Wiggenhall & Terrington St John , &

North Norfolk North Walsham Beeston Regis, Saxthorpe & Aldborough Fakenham

Norwich City Centre East City Centre West Eaton Lakenham & Tuckswood Mile Cross New Catton & Mousehold North University and Avenues

South Norfolk Hingham, Morley & , & Easton Harleston & Pulham & Queens Hills Mulbarton, & , & .

For assistance in identifying where your care setting is within this area or nearby please follow this link and insert your postcode https://coronavirus-staging.data.gov.uk/details/interactive-map

The rationale by which these areas have been identified is set out in the framework below. They are areas in which there is high and increasing infection rate, local sustained transmission and

multiple outbreaks nearby.

We will review these areas every two weeks. If the introduction of the new tests means we do so sooner, we will.

To enable a more restricted level of visiting, providers are asked to have a visiting policy communicated to families, residents and staff.

The above applies unless there are exceptional individual circumstances such as end of life care. We understand that you may need to agree an exceptional visit at short notice and out of hours.

For all other care providers in Norfolk and those adjacent to the areas highlighted above we ask that you revisit your assessment of risk to ensure safety for all reflecting individual and group circumstances as well as the increasing rates of Covid-19 across the County.

To find out more including advice and guidance on visiting arrangements, policy requirements or about current status please contact: Care Provider Incident Room (CPIR): Email: [email protected] Telephone: 01603 257231.

Current government guidance on care home visiting under the new build arrangements is available here https://www.gov.uk/government/publications/visiting-care-homes-during-coronavirus/update-on-policies-for- visiting-arrangements-in-care-homes

Your ongoing support to ensure we protect ourselves, protect others and protect Norfolk is very much appreciated.

Yours sincerely

Dr S.J. Louise Smith, MB ChB, PhD, FFPH Director of Public Health Norfolk County Council

Gary Heathcote, Director of Commissioning Adult Social Services Norfolk County Council

Rationale behind recommendations

Risk level Definition Action National 7 day incidence rate of <100 cases per Current national guidance on care 100,000 and no evidence of high risk local home visiting should be followed outbreak Enhanced Areas in which there is a rapid rise in Enhance precautions for visiting COVID-19 cases or a 7 day incidence rate should be implemented including, of >100/100k and/or on going outbreaks but not limited to; that pose a risk to transmission to the local community v. Visits taking place in designated areas outside of main building with screens in place vi. Window visits vii. Outdoor visits with social distancing viii. Video calls or ‘virtual visits’

Review in 2 weeks