COVID-19 resources

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Evaluating the importance of scale in proposals for local government reorganisation

Pricewaterhouse Coopers LLP

The purpose of this report is to consider the importance of scale in proposals for local government reorganisation. Throughout the report, the implications for the organisation and delivery of children and adults’ social care services are discussed. The report identifies considerations relating to the costs associated with disaggregation; what this might mean in terms of risk and resilience of service provision; how service performance might be impacted; what it could mean for the place agenda; and issues arising from the response to Covid-19. It also sets out the financial implications of four unitary scenarios: establishing one unitary authority in every two-tier area in England; establishing two new unitary authorities in every two-tier area in England; establishing three new unitary authorities in every two-tier area in England; and establishing two new unitary authorities and a children’s trust in every two-tier area in England.

Last updated on hub: 01 September 2020

Covid-19 infection and attributable mortality in UK long term care facilities: cohort study using active surveillance and electronic records (March-June 2020)

medRxiv

This article is a preprint and has not been peer-reviewed. The lead researcher was Peter F Dutey-Magni. Background: Rates of Covid-19 infection have declined in many countries, but outbreaks persist in residents of long-term care facilities (LTCFs) who are at high risk of severe outcomes. Epidemiological data from LTCFs are scarce. This study used population-level active surveillance to estimate incidence of, and risk factors for Covid-19, and attributable mortality in elderly residents of LTCFs. Methods: Cohort study using individual-level electronic health records from 8,713 residents and daily counts of infection for 9,339 residents and 11,604 staff across 179 UK LTCFs. This study modelled risk factors for infection and mortality using Cox proportional hazards and estimated attributable fractions. Findings: 2,075/9,339 residents developed Covid-19 symptoms (22.2% [95% confidence interval: 21.4%; 23.1%]), while 951 residents (10.2% [9.6%; 10.8%]) and 585 staff (5.0% [4.7%; 5.5%]) had laboratory confirmed infections. Confirmed infection incidence in residents and staff respectively was 152.6 [143.1; 162.6] and 62.3 [57.3; 67.5] per 100,000 person-days. 121/179 (67.6%) LTCFs had at least one Covid-19 infection or death. Lower staffing ratios and higher occupancy rates were independent risk factors for infection. 1,694 all-cause deaths occurred in 8,713 (19.4% [18.6%; 20.3%]) residents. 217 deaths occurred in 607 residents with confirmed infection (case-fatality rate: 35.7% [31.9%; 39.7%]). 567/1694 (33.5%) of all-cause deaths were attributable to Covid-19, 28.0% of which occurred in residents with laboratory-confirmed infection. The remainder of excess deaths occurred in asymptomatic or symptomatic residents in the context of limited testing for infection, suggesting substantial under-ascertainment. Interpretation: 1 in 5 residents had symptoms of infection during the pandemic, but many cases were not tested. Higher occupancy and lower staffing levels increase infection risk. Disease control measures should integrate active surveillance and testing with fundamental changes in staffing and care home occupancy to protect staff and residents from infection.

Last updated on hub: 31 August 2020

Guidance for supporting vulnerable and disadvantaged learners

Welsh Government

This guidance provides specific advice for supporting vulnerable and disadvantaged learners returning to school setting in Wales. A wide definition of vulnerable and disadvantaged learners has been adopted, including learners who are in one or more of the following groups: learners with special educational needs (SEN); learners from minority ethnic groups who have English or Welsh as an additional language (EAL/WAL); care-experienced children, including looked after children; learners educated other than at school (EOTAS); children of refugees and asylum seekers; Gypsy, Roma and Traveller children; learners eligible for free school meals (eFSM); young carers; and children at risk of harm, abuse or neglect. The guidance covers: the legislative background; preparing an approach from September 2020; and preparing for a further lockdown or blended learning approach.

Last updated on hub: 27 August 2020

The experience of care home staff during Covid-19: a survey report by the QNI’s International Community Nursing Observatory

The Queen's Nursing Institute

Findings of a survey a survey to understand more about the impact of Covid-19 on the care home nurse workforce within the UK. The survey was distributed online via the QNI Care Home Nurse Network (n~400 members), ranging from staff delivering care directly to residents, to leaders overseeing several homes. There was a total of 163 responses to the survey, equating to a response rate of 41%. The analysis shows that for the majority of respondents working through the pandemic resulted in very negative experiences such as not being valued, poor terms and conditions of employment, feeling unsupported/blamed for deaths, colleagues in other areas refusing help, feeling pressured to take residents from hospitals with unknown Covid-19 status and lack of clear guidance. 66% of respondents reported always having appropriate PPE and 75% reported that their employer had provided all their PPE. During March and April 2020, 21% reported receiving residents from the hospital sector who had tested positive for Covid-19 in hospital and 43% reported receiving residents from the hospital with an unknown Covid-19 status. Being able to access other services was an issue for some respondents. A significant proportion of respondents reported it was somewhat difficult or very difficult to access hospital care, GP services, District Nursing services, end of life medication/services. 56% of respondents felt worse or much worse in terms of their physical and mental wellbeing, while 36% reported no change. Only 62 respondents stated that they could take time off with full pay, while some felt pressure not to take time off at all.

Last updated on hub: 27 August 2020

COVID-19 and the female health and care workforce: survey of health and care staff for the Health and Care Women Leaders Network, August 2020

NHS Confederation

This report sets out the findings of a survey to understand the impact the Covid-19 pandemic has had on women working across health and care services. A total of 1,308 women responded to the survey. While the overwhelming majority of respondents to the survey were white, there were some key differences in the findings in relation to participants from black and minority ethnic (BME) backgrounds. The survey found that most respondents – almost three-quarters – had reported that their job had a greater negative impact than usual on their emotional wellbeing as a result of the pandemic, and more than half had suffered a negative impact on their physical health. Staff from BME backgrounds also reported feeling traumatised by the disproportionate impact of the virus, compounded by concerns over risk assessments not being performed in a timely manner, if at all. In addition, the analysis shows that PPE availability and training have been broadly adequate, but could be stronger; managerial support has been strong, but some issues emerge over sharing concerns; struggles with work-life balance since lockdown started; some respondents had safety concerns when working from home. The report also draws out some of the positive experiences, such as opportunities for learning and the strength of support many have received from their managers. Recommendations to improve the working conditions for women in health and care services are included.

Last updated on hub: 27 August 2020

Overview of adult social care guidance on coronavirus (COVID-19)

Department of Health and Social Care

Brings together information for adult social care providers on COVID-19 guidance and support. The resource covers help with infection prevention and control; what to do when you suspect an outbreak; reporting an outbreak; caring for patients discharged from hospital or another social care facility; visits to care homes and other care settings; information for providers of care in supported living and domiciliary settings; how to get social care workers and people in care homes tested; managing care workers during COVID-19; securing PPE and related supplies; help for holders of direct payments, commissioners and care providers; information for social care providers on mental health and wellbeing and financial support; Capacity Tracker and guidance on using it; information for unpaid carers; easements of the Care Act; COVID-19 ethical framework for adult social care; caring for people who are protected by safeguards under the Mental Capacity Act 2005, including the deprivation of liberty safeguards; steps to take following a coronavirus-related death of a person who worked in adult social care.

Last updated on hub: 27 August 2020

How has Covid-19 and associated lockdown measures affected loneliness in the UK?

What Works Centre for Wellbeing

This briefing highlights findings from the Covid Social Study, a research project run by University College London, exploring the effects of the virus and social distancing measures on adults in the UK during the outbreak of COVID-19. Data collected by the study from over 70,000 people has shown how loneliness has been affected between March and July 2020. It provides insights into how many people have been lonely during this uncertain time and what the risk factors are that policy makers and practitioners should recognise in their efforts to alleviate loneliness. The initial analysis of the data shows that people who felt most lonely prior to pandemic now have even higher levels of loneliness. This increase began as physical distancing and lockdown measures were introduced in the UK, in March 2020. Adults most at risk of being lonely, and increasingly so over this period, have one or more of the following characteristics: they are young, living alone, on low incomes, out of work and, or with a mental health condition. The impact on wellbeing from people at risk of loneliness is likely to be compounded by other economic and social impacts experienced by the same people, such as those experiencing job losses and health anxieties.

Last updated on hub: 27 August 2020

Covid-19 and the nation’s mental health: forecasting needs and risks in the UK: July 2020

Centre for Mental Health

This briefing draws on international evidence to provide an assessment of the economic impacts of Covid-19 and their implications for public mental health. It also reviews evidence relating to the criminal justice system and to young adults and the potential longer-term psychological impacts of rising youth unemployment. Research has identified specific groups of people facing higher risks to their mental health at this time, including the families of people treated in intensive care, people with existing mental or physical health conditions, and pregnant women. There is also evidence that people with existing mental health difficulties have been experiencing a worsening of their mental health during the pandemic. The impact of the pandemic on children and young people’s mental health is greater in areas and communities hardest hit by the virus and by lockdowns. Children from low income families, from Black, Asian and minority ethnic communities and young carers are all more likely to experience poor mental health as a result of the pandemic. Children’s mental health has been affected by disruptions to their education, compounded by reduced access to support for their mental health. The paper makes a number of recommendations for action to protect the nation’s mental health, including: targeting mental health resources where they are most needed; proactively protecting the mental health of children and young people; facilitating a psychologically informed return to school; providing additional mental health support for groups facing further risks; improving safety in the criminal justice system; and supporting young people seeking employment.

Last updated on hub: 27 August 2020

How has COVID-19 changed the landscape of digital inclusion?

Centre for Ageing Better

This briefing looks at how COVID-19 has impacted older people's internet use and sets out recommendations to help ensure fewer people are digitally excluded. The paper identifies multiple and complex barriers that individuals in later life face in getting online, including self-efficacy or lack of confidence; awareness of benefits; awareness of risks; employment history; perception of cognitive ability; influence of family; perceived value and relevance; and access and affordability of equipment. The paper suggests that there are some consistent principles of good practice that can be applied to the support offered to older people. They include: flexibility and relevance – helping people to do the things they need and want to do online; the right pace; repetition and reflection; the right language, avoiding jargon and focusing on the task, not the tech; a strong teacher-student relationship; time to build relationships; ongoing, open-ended support, allowing learners to return with questions and problems; and co-design, involving a wide range of users in the shaping and design of all services, new and existing, to ensure their relevance and effectiveness.

Last updated on hub: 27 August 2020

Community health and care discharge and crisis care model: an investment in reablement

Local Government Association

This paper sets out the view of the Local Government Association (LGA) and Association of Directors of Adult Social Care (ADASS) that the ‘discharge to support recovery and then assess’ approach is a key component of a person-centred community health and care model. The experience of responding to COVID19 has demonstrated the importance of this care being centred on the individual, providing safe, proactive care that maximises independence and wellbeing. The paper argues that people have the best outcomes when they are helped to avoid having to go to hospital or return home from hospital safely and without delay, with support targeted on their needs. Once settled back into their homes, and after a period of reablement or rehabilitation if needed, only then should they have a care and health assessment for any ongoing needs. However, the paper suggests that but there are not enough community-based services to support people at home – the 2020 ADASS Budget Survey highlights that only 4 per cent of directors of adult social services are confident their budgets will enable them to meet statutory duties. The Covid-19 crisis has confirmed the need to reshape health and care, embedding positive developments and preventing a return of fragmented and untimely care and support, especially on discharge from hospital. This will require government and national partners to support local place-based leadership, to continue to shift resources towards community-based services, and to support the recruitment, retention and retraining of the workforce.

Last updated on hub: 27 August 2020