What is the NICE guidance around clinical decision-making?

Arrangements for end point assessments can be modified or rescheduled. End point assessment organisations should engage with External Quality Assurance Providers to agree arrangements for the end point assessments where face-to-face assessments are being modified. Where rescheduling is required due to Covid-19 issues and there is a specified time limit for the ESA post gateway, a further pause of 12 weeks is allowable. This should be recorded by the training provider in the ILR.

There is no simple answer.

The NFCC guidance states:

“The person-centred fire risk assessment is intended only as a simple means for non-specialists who have suitable understanding of relevant fire risks to determine whether additional fire precautions might be needed. The person who carries out the person-centred fire risk assessment will depend on the circumstances of the housing and support provision. It can be carried out by those who regularly engage with the resident, with input from specialists where necessary. Assessments will normally be undertaken with residents themselves.

In sheltered housing with scheme managers, the scheme managers normally engage with residents on a routine basis, enabling residents who need a person-centred fire risk assessment to be identified. Many vulnerable residents will be in receipt of care, so enabling the care provider to identify residents in need of a person-centred fire risk assessment. Providers of regulated care are required to take into account risks to people from their wider environment, to take steps to help people ensure that they are dealt with by appropriate agencies, or to raise safeguarding alerts when this is appropriate. Where a ‘stay put’ strategy is adopted, there will be a need to identify residents who need assistance from the fire and rescue service to evacuate the building.

In supported housing, the number of residents in each property is usually quite small. This, and the nature of the care service normally provided, enables person-centred fire risk assessments to be carried out asa matter of course, when a resident first moves into the property.

Where additional fire precautions cannot be provided in the short term, the risk should be reduced as far as reasonably practicable and an adult at risk referral should be made to Adult Social Care.”

Ideally then the RP will need to engage with any care providers in order to conduct the PCRA and identify risk mitigation measures. If they are reluctant to do so, the RP should engage with the individual in any event in undertaking the assessment.

It is the individual assessment by an organisation of its Covid-19 risk in its workplace that will be central. There may be common features across sites or areas of a site but every workplace will have a different risk profile depending on the service it offers and the workers who deliver those services.  No one size fits all.

The context of managing Covid-19 risk is the need to tie in with UK government guidance and HSE advice – which despite being a lot more comprehensive than it was, is not a panacea and will continue to evolve.  The difficulty we have with this in the context of the known increased risk to BAME employees from Covid-19 is that our understanding of the risk is, we would suggest, at a pretty early stage which makes it more difficult to address. However we know the increased risk exists and we owe our BAME workers a duty to manage that risk and keep them safe.

We also have a duty to consult employees.  This is critical in managing this risk – ensuring BAME workers have a loud voice in the assessment process will be very important.

Where an individual has a particular characteristic, for instance they’re pregnant, they have physical or mental disabilities etc, the law requires us to look at that individual or, where it is a group, that group of individuals and assess the risk to them and take any reasonably practicable steps to control the risk to them.

Risk control hierarchy is key. In “normal” businesses we reduce our Covid-19 risk by keeping people away from the workplace – “avoid, eliminate and substitute” then changing work practices (e.g. social distancing measures) before we arrive at PPE. In a healthcare context, we arrive at PPE a lot more quickly.

We need to ensure our people are given sufficient information, instruction and training so they can do their jobs safely and we must consult workers and involve them in workplace safety – this is going to be critical in the context of Covid-19.

Details of your MHFAs should be posted somewhere that everyone can access easily – a specific area on an intranet or whatever alternative exists. Regular comms involving the MHFAs, webinar sessions, Q&A sessions and mental wellbeing drop in sessions are all ideas that may work well.

We are working with many of our clients to progress with stopping up applications in order to divert/stop up highways and public rights of way affecting development sites. Due to lockdown restrictions the Department for Transport stalled the progress of applications because they were unable to comply with the statutory publicity requirements. We have very recently been contacted by the Department for Transport casework team who have confirmed that the stopping up/diversion applications can now be progressed. We are aware that Councils across the country are also now progressing with applications. Please contact us if you require any advice/assistance in respect of your application.