Coronavirus (COVID-19)

Stakeholder Guidance for people working for or receiving services from Outreach Rescue / ORMS

Key Information

Outreach Rescue / ORMS, Current Lockdown Status

Wales is operating under “Alert Level 4” and a set of measures aimed at reducing the risk of spreading the virus.

We would classify this as being in the equivalent category of ‘High‘ on the scale used by the English Government.

This means that you can attend training at our centre.

However, if you are travelling from an area under local lockdown restrictions you must be a KEY WORKER and the training must be ESSENTIAL for you to perform your role.

We are located in Llanllechid, Bangor, Gwynedd, North Wales.

Check the Welsh Government website for up to the minute information.

Please read on for more information…

Our Coronavirus measures are overseen by our Lead Clinician, Consultant Paramedic, Jason Williams. If you have any question then please contact him on jason@orms247.net

Introduction

The UK is currently experiencing a public health emergency as a result of the COVID-19 pandemic. It is critical that businesses take measures to keep staff and customers safe.

This guidance is to help employees and customers understand how we are responding as an organisation.

As you would expect for Outreach Rescue / ORMS, we have approached this issue with full regard to Government guidance (including the devolved administrations) and scientific advice to arrive at a set of measures that we believe are lawful, appropriate, evidence based and in the best interests of all our stakeholders.

We hope this guidance provides you the information you need to work safely with us and to assure you that both your staff and ours are being looked after.

We expect that this guidance will be updated over time. Please come back to this page for further releases.

Definitions

Key Workers
  • Health and social care
    • Including but not limited to doctors, nurses, midwives, paramedics, social workers, care workers, and other frontline health and social care staff including volunteers; the support and specialist staff required to maintain the UK’s health and social care sector; those working as part of the health and social care supply chain, including producers and distributors of medicines and medical and personal protective equipment.​
  • Education and childcare
    • This includes childcare, support and teaching staff, social workers and those specialist education professionals who must remain active during the Covid-19 response to deliver this approach.​
  • Key public services
    • This includes those essential to the running of the justice system, religious staff, charities and workers delivering key frontline services, those responsible for the management of the deceased, and journalists and broadcasters who are providing public service broadcasting.​
  • Local and national government
    • This only includes those administrative occupations essential to the effective delivery of the Covid-19 response, or delivering essential public services, such as the payment of benefits, including in government agencies and arms length bodies.​
  • Food and other necessary goods
    • This includes those involved in food production, processing, distribution, sale and delivery, as well as those essential to the provision of other key goods (for example hygienic and veterinary medicines).​
  • Public safety and national security
    • This includes police and support staff, Ministry of Defence civilians, contractor and armed forces personnel (those critical to the delivery of key defence and national security outputs and essential to the response to the Covid-19 pandemic), fire and rescue service employees (including support staff), National Crime Agency staff, those maintaining border security, prison and probation staff and other national security roles, including those overseas.​
  • Transport
    • This includes those who will keep the air, water, road and rail passenger and freight transport modes operating during the Covid-19 response, including those working on transport systems through which supply chains pass.​
  • Utilities, communication and financial services
    • This includes staff needed for essential financial services provision (including but not limited to workers in banks, building societies and financial market infrastructure), the oil, gas, electricity and water sectors (including sewerage), information technology and data infrastructure sector and primary industry supplies to continue during the Covid-19 response, as well as key staff working in the civil nuclear, chemicals, telecommunications (including but not limited to network operations, field engineering, call centre staff, IT and data infrastructure, 999 and 111 critical services), postal services and delivery, payments providers and waste disposal sectors.​

Essential (in the context of clients coming to the Outreach Centre, North Wales

​Your attendance on the course is only essential if you can answer “YES” to ALL of the following.​

  1. Failure to undertake the course will prevent you from performing your Key Worker role.​
  2. Postponing the course will prevent you from performing your Key Worker role.​
  3. Your attendance on the course is mandated by your employer in order that essential (Key worker services) can continue to be delivered by your organisation.​
  4. It is not possible to undertake the course at distance or on-line with Outreach/ORMS
Essential (in the context of Outreach Rescue / ORMS sending staff to provide services elsewhere in the UK

Course delivery is only essential if you can answer “YES” to ALL of the following.

  1. ​Failure to deliver the course will prevent a client/delegate from performing their Key Worker role.​
  2. Postponing the course will prevent the client/delegate from performing their Key Worker role.​
  3. ​The organisation receiving the course provides a mandated Key Worker service and is reliant on course delivery for continuation of the Key Worker service.​
  4. It is not possible to undertake the course at distance or on-line with Outreach/ORMS​
Risk Stratification of local areas

As Wales, England, Scotland and Northern Ireland have differing ways of expressing the lockdown level within their own juristiction, Outreach Rescue / ORMS has found it necessary to compare the measures taken and attempt to categorise them so that a robust decision making process can be devised.

Whilst it is understood that the law still allows for people to travel for work and education into and out of areas of “Very High” risk. Outreach Rescue / ORMS must take this information and balance it against the need to provide a healthy and safe working / learning environment. Therefore, we have taken the decision to only allow services to take place in areas of “Very High” risk or for clients to be received at the Outreach centre from areas of “Very High” risk, if the service we are providing is:

  • Essential
  • Safe
  • Legal
  • Compliant
Screening

Currently, no screening process can be 100% reliable in identifying all cases of SARS CoV-2. However, a multi-layered approach to screening and rigorously enforced process of hygeine, face coverings and social distancing are proved to reduce the spread of infection.

Anyone attending the Outreach ORMS centre must consent to having their results retained by us in accordance with the retention of clinical date retention and consent to us using this date to report to the relevant authorities.

Screening Tools

Clinical Questioning – A verbal assessment by a clinician has a greater value in the screening of illness than a simple questionaire. Therefore, Outreach ORMS requires all attendees to complete a self declaration medical form followed by a back up call from a clinical professional if there are any causes for concern highlighted.

The following clinical questions are used to guide the process:

Please answer ‘true’ or ‘false’ to each of the statements below.

  1. You do not have a new, continuous cough  
  2. You do not have a loss, or change in, normal sense of taste or smell  
  3. You do not live with, and have had close contact with, a person who has tested positive for COVID-19 within the past 14 days 
  4. If traveling from a restricted country, you have undertaken the requisite days of quarantine prior to your attendance on this course 
  5. If you have had a positive COVID-19 test result or have been self-isolating for any other reason, you have agreement from your line manager to return to work. 
  6. You agree to have the results of this screening stored by ORMS / Outreach Rescue for a period of one year. 

Temperature Checks – A high temperature is usually considered to be 38C or above. This is sometimes called a fever. Many things can cause a high temperature, but it’s usually caused by your body fighting an infection.

There is little scientific evidence to support temperature screening as a reliable method for detection of COVID-19 or other febrile illness, especially if used as the main method of testing. However, when combined with clinical questioning and other screening tools it can form part of a layered approach.

Temperature readings from non-contact temperature screening systems measure skin temperature rather than core body temperature. In either case, natural fluctuations in temperature can occur among healthy individuals. These readings are therefore an unreliable measure for detection of COVID-19 or other diseases which may cause fever. Furthermore, infected people who do not develop a fever or who do not show any symptoms would not be detected by a temperature reading and could be more likely to unknowingly spread the virus. 

Screening and temperature testing are not a substitute for COVID testing, but when combined with careful attention to hygiene and distancing procedures will assist in the reduction of infection and transmission. Therefore all tutors, facilitators and delegates are required to follow hygiene and distancing measures at all times during the course.

The procedure for temperature screening is as follows:

  1. Non-contact temperature testing (NCTT-1) 
  2. If NCTT-1 is high then, Non-contact temperature testing (NCTT-2) 
  3. If NCTT-2 is high then, Oral temperature testing (OTT-3)
  4. If OTT-3 is high then, the individual will be treated as a possible case of COVID-19 (see the Risk Register for control measures to be applied.

Lateral Flow Testing – Lateral flow tests are designed to identify the presence of a specific biological marker. Pregnancy tests, for example, look for the hormone hCG.

Lateral flow testing is a quick and easy to administer process that can assist in screening programmes. However, we should be reminded that it is merely a spot check (a bit like an MOT), showing that at that point the individual did not have any of the markers that the test is sensitive to.

Lateral flow testing programmes should be overseen by a health care professional and ensure that all necessary reporting mechanisms are in place for positive results and failed tests.

Lateral Flow Testing compliance is as follows:

The individual must provide evidence of a NEGATIVE SARS CoV-2 Lateral Flow Test from within the last 24hrs of attendance at the centre. If the individual cannot provide such evidence then they will be required to submit to a Lateral Flow Test from Outreach ORMS prior to any course activities (this test is mandatory).

If the individual would like a further test at the end of the course for reassurance prior to returning home, then they can arrange this through their lead tutor during their attendance.

All Lateral Flow Testing facilitated by Outreach ORMS is subject to a charge of £15.00 inc VAT per test.

If you have any questions with regards SARS CoV-2 screening then please contact our lead clinician, Jason Williams jason@orms247.net

Pre-Attendance Screening

All delegates are required to complete a pre-attendance “Medical Declaration and Consent Form”. This form collects data from the individual so as to assist Outreach Rescue / ORMS in managing their attendance safely.

Part of the form is dedicated to COVID-19 screening, the health and wellbeing of our students, visitors and staff is our priority. Therefore, Outreach Rescue / ORMS may deny access to the site dependant on the information provided. In addition, if anything changes in the period between completing the form and the delegates attendance then they must make contact with us to discuss.

If any areas of concern are expressed on the form then a clinical member of Outreach Rescue / ORMS staff will make contact to conduct a telephone assessment (Clinical Questioning) of the individual and their suitability to attend.

Attendance Screening

Attendance screening is managed in two ways dependant on the length of the course:

Single day course – On a single day course the student must complete;

  1. Pre-Attendance Screening
  2. Lateral Flow Test Screen

Multiple day course (a course consisting of more than 1 day in succession) – On a multiple day course the student must complete;

  1. Pre-Attendance Screening
  2. Lateral Flow Test Screen
  3. Daily Checks – Consisting of a Temperature Screen and Clinical Questioning

At the start of each teaching day all Outreach Rescue / ORMS staff and all course delegates will undergo a two-stage process of screening;

  1. Clinical questioning 
  2. Temperature testing 

TRAVELLING TO the Outreach Centre, Bangor North Wales

TRAVELLING FROM Outreach Rescue / ORMS to deliver services elsewhere in the UK

Managing Risk

As an organisation we understand that we have a legal responsibility to protect workers and customers from risk to their health and safety.

This means that we are seeking to ensure that we have thought about the risks they face and that we do everything reasonably practicable to minimise them, recognising that we cannot completely eliminate the risk of COVID-19.

We have developed a new section within our organisational Risk Register, that specifically addresses the challenges caused by COVID-19. These challenges are evolving and include not just health related issues but also how we conduct our business in an environment where there are a variety of rules imposed upon movement, social distancing and allowed activities. Scroll to the bottom to see our COVID-19 Risk Register at the end of this page.

Hazard IdentifiedRisk Score Without Control MeasuresDesired GoalControl MeasuresRisk Score With Control Measures Applied
Staff/client illness due to contracting COVID19 from work / training activities.16 – HighStaff are protected as far as possible from contracting COVID-19 as a consequence of work activities.Government advice is that up to 80% of the population will contract the virus with the majority of cases resulting in an illness that is self-limiting at up to 1 month.

It is not possible to eliminate the risk completely of staff contracting COVID-19 as a result of working activities.

Mitigation of risks falls to Safe Systems of Work (SSoW) and Personal Protective Equipment (PPE). Provision of PPE to meet current recommendations. Alterations to work practices to reduce the risk of virus spread.
6 – Low
Staff/clients not aware of updated / adjusted policies and procedures20 – HighStaff/Clients are aware of the relevant policies / proceduresAll staff / clients are made aware of all relevant policies and procedures through organisational communication system (teams) and joining instructions. – All staff undergo re-induction post furlough to raise awareness of the new procedures and safety precautions.3 – Low
Cleaning could be insufficient to manage the risk of virus spread16 – HighCleaning procedures and practices are suffiecient to reduce the risk of virus spreadAdditional staff have been recruited to facillitate increased cleaning need.

A new cleaning schedule is developed that ensures cleaning is generally enhanced and includes:
– More frequent cleaning of rooms and shared areas (including classrooms, living areas, offices, and eating areas) that are used by different groups
– Frequently touched surfaces being cleaned more often than normal
– Provision for ensuring toilets are cleaned more regularly
– Dining areas are cleaned between use by different bubbles
– Classroom resources, e.g. books, manikins and training equipment are cleaned regularly
– Resources that are shared between bubbles, e.g. safety equipment, are regularly cleaned and thoroughly cleaned before they are shared between bubbles. Some resources are rotated to allow them to be left unused and out of reach for a period of 48 hours or 72 hours where possible between use by different bubbles.
6 – Low
Staff / clients who are unwell may bring the virus into the workplace12 – MediumEnsure staff / clients are aware of Outreach ORMS rules on quarantine prior to attendanceAll clients are required to complete a medical questionairre prior to arrival at the centre. Anyone who displays symptoms of coronavirus, or who has tested positive in the last 14 days, will not be allowed access to the training centre.

Clients are informed via joining instructions that students will not be permitted onsite if they have been syptomatic within the last 14days or if they arrive with a temperature or other symptoms.

Instances of staff / clients displaying coronavirus are managed in line with local and national guidance and the Infection Control Policy.

Any unwell individuals are sent home as soon as possible. If residential, the student will be confined to their room and welfare will be arranged until a Polymerase Chain Reaction (PCR) Covid Test has been completed. If the PCR test is positive then the employer/responsible individual will complete the necessary arrangements to transfer the student to an appropriate location in an appropriate manner. If the PCR test is negative then the student may rejoin the course activities if appropriate and the student feels well enough for this to occur.

Staff are informed of the symptoms of possible coronavirus infection, e.g. a new continuous cough, loss of smell, difficulty breathing and a high temperature, and are kept up-to-date with national guidance about the signs, symptoms and transmission of coronavirus.

Outreach ORMS routinely take the temperature of staff/clients each morning and on first arrival at the centre. Any staff / client who displays any symptoms is immediately sent home.

The employer of an unwell student is informed of the situation as soon as possible by a member of staff. Where contact with a clients employer cannot be made, appropriate procedures are followed in accordance with those outlined in governmental guidance.

Staff / clients awaiting collection are moved to a room where they can be isolated behind a closed door. If it is not possible to isolate the individual, they are moved to an area that is at least two metres away from others. Depending on the condition of the individual, they are supervised if needed.

If the individual needs to use the toilet while awaiting collection, they will use a spare bathroom. The bathroom is then cleaned and disinfected using standard cleaning products before being used by anyone else.

PPE is worn by supervising staff if they cannot maintain a distance of two metres.

Staff members who have helped someone with symptoms and any other staff / clients who have been in close contact with them do not need to self-isolate unless they develop symptoms themselves or the symptomatic individual subsequently tests positive.

The attending member of staff calls for emergency assistance immediately if the individual’s symptoms worsen.

The area around the unwell individual is cleaned with normal household bleach after they have left the premises.
3 – Low
Individuals may not be aware of the need to take part in Test and Trace6 – LowIndividuals are aware of the needEmployers / Clients / Staff are informed that they may need to engage with the NHS Test and Trace programme, meaning they need to be ready and willing to:
– Book a test if they (or their employee) display symptoms
– Provide details of anyone they (or their employee) have been in close contact with if they were to test positive for coronavirus or are asked by NHS Test and Trace
– Self-isolate if they have been in close contact with someone who develops coronavirus symptoms or someone who tests positive

Employers of individuals who display coronavirus symptoms are encouraged to get their other employees tested where appropriate.
– Employees / Clients / Staff are asked to inform Outreach ORMS immediately of test results.

If an individual tests positive, they are required to self-isolate for at least 14 days from the onset of symptoms and then return to their course (if applicable) only if they do not have symptoms other than a cough or loss of sense of smell / taste.
2 – Low
Identification of actions to take should a Confirmed Case of Coronavirus be reported12 – MediumRobust process for the management of reported cases in placeEmployees are informed of how Outreach ORMS responds to confirmed cases of coronavirus.

Where an individual in the Outreach ORMS staff or Clients tests positive for coronavirus, the senior clinician at Outreach ORMS contacts the local Health Protection Team (HPT) immediately.
– Outreach ORMS works with the local HPT to manage the response. Individuals at Outreach ORMS who have been in close contact with someone who has tested positive are sent home immediately. Close contact is defined as follows:
– Direct close contacts
– face-to-face contact with an infected individual for any length of time, within one metre, including being coughed on, a face-to-face conversation, or unprotected physical contact (skin-to-skin – Proximity contacts – extended close contact (within one to two metres for more than 15 minutes) with an infected individual
– Travelling in a small vehicle, like a minibus, with an infected person.

A record is kept of clients and staff in each bubble and of any close contact between individuals at Outreach ORMS.

If required, all other employers are informed of the confirmed case; however, the name of the individual is not shared.

If Outreach ORMS has two or more confirmed cases of coronavirus within 14 days, or an overall rise in sickness absence where coronavirus is suspected, Outreach ORMS will continue to work with the local HPT who will advise on additional actions.
3 – Low
Individuals may not be compliant with advised hygeine practices9 – MediumAll individuals comply with guidance of hygeineFace coverings will be available on request, but clients are encouraged to bring their own to be worn when required during training activities. They will be required to wear them when being transported in Outreach ORMS minibus’ or if engaging in activities where social distancing cannot be maintained.

Staff and clients are encouraged to wash their hands regularly, including when they arrive at the centre, when they return from breaks, when they change rooms, and before and after eating.

Posters are displayed throughout the centre reminding individuals to wash their hands regularly. Sufficient amounts of soap (or hand sanitiser where applicable), hot water, paper towels and lidded bins are supplied in relevant areas.

Individual risk assessments are conducted in relation to individuals with complex needs (disability, pre-existing medical contitions, vulnerable family members).

Individuals whose behaviour is purposefully contrary to the infection control measures in place will be informed that they may be asked to leave the premisis.
6 – Low
Social distancing difficulties dependant on role or function being performed16 – HighAbility to maintain social distancing or adjustment to activities to allow social distancing whilst still meeting required learning outcomesThe number of students on a training course is reduced depending on classroom sizes. For most courses this will be max 6 students.

Visual aids are used to display social distancing measures in common areas.

Clients and staff are separated into groups (or ‘bubbles’)

Classrooms, practical workspaces and practical activities are adapted to support social distancing, including seating arrangements and moving furniture out of classrooms to allow more space.

Clients are encouraged to queue two metres apart at entrances and exits.

Breaktimes and lunchtimes are staggered to reduce the number of individuals congregating in break and lunch areas at once.

Implementation of other social distancing measures where necessary, e.g. one-way systems in busy areas

Individuals whose behaviour is purposefully contrary to the infection control measures in place will be informed that they may be asked to leave the premisis.
9 – Medium
Risk of virus transfer on training or shared office resources12 – MediumVirus is not allowed to be transferred through contact with reourcesStaff and clients have their own individual and frequently used items, e.g. pencils and pens.

Classroom resources, e.g. books and practical equipment, can be shared within a bubble and are cleaned regularly.

Resources that are shared between bubbles, e.g. rescue equipment, are cleaned before they are used by a different bubble or rotated to allow them to be left unused for 48 to 72 hours where possible, between use by different bubbles.
6 – Low
Individuals may not be aware of the measures in place with regards to Coronavirus9 – MediumEnsure everyone is informedOutreach ORMS keeps clients and their employers updated about any changes to Outreach ORMS procedures as necessary.

Outreach ORMS communicates with employers and clients via website, social media, joining instructions, email or letter regarding any changes to procedures that are affected by the coronavirus pandemic, whether their employee will be able to attend the centre, and what protective measures Outreach ORMS is implementing to keep their employee safe. Individuals attending the centre are informed of social distancing rules and how to maintain good levels of personal hygiene.
3 – Low
Staff Welfare, consideration for a debrief procedure and subsequent welfare9 – MediumStaff are protected as far as possible from mental health illness as a consequence of work activities.Development of a peer support network to be offered to all staff along with a hotline to seek help.

Sickness procedure to ensure staff are aware of appropriate action if they become unwell.
6 – Low
Reduction in the quality of learning due to the impact of coronavirus safety measures12 – MediumEnsure learning outcomes are met and that quality of service is maintainedThe management team and curriculum leaders work with teaching staff to identify curriculum priorities and ensure a plan is in place to provide adequate learning material. The management team and curriculum leaders identify what provision can be reasonably provided for individuals by utilising distance or blended learning techniques. The management team and curriculum leaders work with teaching staff to ensure education can continue to be delivered to all individuals who are learning remotely, e.g. those sent home to self-isolate as a precaution or as a part of their normal course delivery plan.

Measures to reduce the risk of infection during practical lessons are implemented, including physical distancing and positioning. Wherever possible lessons take place outside and individuals are kept in consistent groups.
6 – Low
Emergency procedures need to operate in conjunction with Coronavirus procedures12 – MediumEmergency actions are as effective as they were prior to coronavirus procedures being implementedAll staff and clients emergency contact details are up-to-date, including alternative emergency contact details, where required.

Employers are contacted as soon as possible in the event of an emergency.

Alternative contacts are called where their primary emergency contact cannot be contacted.

Outreach ORMS has an up-to-date First Aid Policy in place which outlines the management of medical emergencies
– medical emergencies are managed in line with the policy.
3 – Low
Travel arrangements for students that develop symptoms of Coronavirus whilst on a course at the centre.12-MediumClarity on who is responsible for the travel arrangements for students showing signs of CoronavirusCommunicate with students / organisations explaining that the booking authority (person or organisation) that has purchased the course remains responsible for the travel arrangements of themselves / their employees.

Should a residential student be required to isolate then this will be facilitated until such time as the responsible person/organisation has arranged for the student to be transferred.
6 – Low
Staff, Students and Organisations may not be aware of the Outreach ORMS approach to screening for SARS CoV-212-MediumEnsure Staff, Students and Organisations are aware of the Outreach ORMS approach to screening for SARS CoV-2Outreach ORMS will seek to ensure it is utilising sound evidence in its approach to screening for SARS CoV-2. Threfore, it may be necessary for this approach to evolve in response to new strains or new evidence.

Outreach ORMS will publish its screening measures on it’s “Coronavirus Page”.
Exerpt from organisational risk register showing risk score prior to and post control measures that we have applied.