COVID-19 resources

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Risk factors for outbreaks of COVID-19 in care homes following hospital discharge: a national cohort analysis


Background: Adult residential and nursing care homes are settings in which older and often vulnerable people live in close proximity. This population experiences a higher proportion of respiratory and gastrointestinal illnesses than the general population and has been shown to have a high morbidity and mortality in relation to COVID-19. Methods: This study examined 3,115 hospital discharges to 1,068 Welsh adult care homes and the subsequent outbreaks of COVID-19 occurring over an 18 week period between 22 February and 27 June 2020. A Cox proportional hazards regression model was used to assess the impact of time-dependent exposure to hospital discharge on the incidence of the first known outbreak, over a window of 7-21 days after discharge, and adjusted for care home characteristics, including size, type of provision and health board. Results: A total of 330 homes experienced an outbreak of COVID-19, and 544 homes received a discharge from hospital over the study period. The exposure to discharge from hospital was not associated with a significant increase in the risk of a new outbreak (hazard ratio 1·15, 95% CI 0·89, 1·47, p = 0·29) after adjusting for care home characteristics. Care home size was by far the most significant predictor. Hazard ratios (95% CI) in comparison to homes of <10 residents were: 3·40 (1·99, 5·80) for 10-24 residents; 8·25 (4·93, 13·81) for 25-49 residents; and 17·35 (9·65, 31·19) for homes of 50+ residents. When stratified for care home size, the outbreak rates were similar for periods when homes were exposed to a hospital discharge, in comparison to periods when homes were unexposed. Conclusion: The analyses showed that large homes were at considerably greater risk of outbreaks throughout the epidemic, and after adjusting for care home size, a discharge from hospital was not associated with a significant increase in risk.

Last updated on hub: 20 February 2021

Risk factors for social isolation among older adults in long term care: a scoping review

Multidisciplinary Digital Publishing Institute

Objectives: A wealth of literature has established risk factors for social isolation among older people, however much of this research has focused on community-dwelling populations. Relatively little is known about how risk of social isolation is experienced among those living in long-term care (LTC) homes. We conducted a scoping review to identify possible risk factors for social isolation among older adults living in LTC homes. Methods: A systematic search of five online databases retrieved 1535 unique articles. Eight studies met the inclusion criteria. Results: Thematic analyses revealed that possible risk factors exist at three levels: individual (e.g., communication barriers), systems (e.g., location of LTC facility), and structural factors (e.g., discrimination). Discussion: Our review identified several risk factors for social isolation that have been previously documented in literature, in addition to several risks that may be unique to those living in LTC homes. Results highlight several scholarly and practical implications [Note: this is a preprint, not peer-reviewed]

Last updated on hub: 28 January 2021

Risk identification and virtual interventions for social workers

Social Care Institute for Excellence

This quick guide will help social workers and practitioners understand how to gather evidence to be able to identify and assess risks normally gathered through observation.

Last updated on hub: 11 November 2020

Rituals in the time of COVID‐19: imagination, responsiveness, and the human spirit

Family Process

Following the format put forth by Imber‐Black and Roberts, this paper examines daily rituals, family traditions, holidays, and life cycle rituals during the pandemic of COVID‐19. Marked by symbols capable of carrying multiple meanings, symbolic actions, special time and special place, and newly invented and adapted rituals are illustrated through stories of couples, families, and communities.

Last updated on hub: 14 October 2020

Roadmap for frontline professionals interacting with male perpetrators of domestic violence and abuse

The roadmap set out in this report aims to assist frontline professionals in health care or social services, child protection services, police, and others, coming into contact with male service users who are violent or abusive to their female partners. Working with these men to change their behaviour is a key step towards preventing domestic violence. The contents of the roadmap are based on a review of the relevant literature and input from frontline professionals, male perpetrators and experts working with perpetrators who agreed to take part in focus groups or interviews in three European countries (France, Italy, Spain) as part of the ENGAGE project. The roadmap consists of introductory chapters to set the stage for engaging perpetrators, covering definitions and consequences of violence and abuse; accountability and victim safety; and beliefs towards men who use domestic violence. A flowchart then introduces the four steps to engage and refer perpetrators: step 1 – identifying domestic violence and abuse in men; step 2 – asking men about domestic violence and abuse; step 3 – motivating men for referral; and step 4 – referring men to perpetrator programmes within a coordinated multi-agency response. A subsequent chapter deals with professional, personal and legal dilemmas professionals might encounter in this work. The last chapter summarises 12 do’s and don’ts when engaging with a perpetrator. The references and an extensive annex of tools and resources complete the roadmap.

Last updated on hub: 15 July 2020

Robotics in care: a moment of opportunity: how robotic technology can transform global social care delivery

PA Consulting Group

This report explores how robotic technology offers an opportunity to transform social care in the wake of COVID-19. The pandemic has raised the prominence of technology in care, meaning many workers now have direct experience of how it can help them do their jobs better, faster and with reduced risk. The report argues that now is the time to rethink and reset traditional care service delivery and leaders must adopt a bolder, more ambitious approach to trialling and deploying robotic technologies to help meet the social care needs of vulnerable residents beyond the crisis. The range of technologies available to leaders includes: collaborative robots (‘cobots’) – designed to be used in conjunction with human; semi-humanoid robots – smart robots with human-like characteristics to facilitate social interaction with people living with dementia or Asperger’s; robotic animals – which can serve as companions to people living with dementia or learning disabilities; digital assistants – voice-controlled devices and services that support people with care needs at home; medicine robots – automated medicine dispensers; and automated call services – to check on vulnerable people, helping local authorities remain in touch and respond sooner when a need emerges. The report describes three practical steps leaders can take to capitalise on robotic technology in earnest: define your strategy based on human outcomes; trial technologies with the aim of deploying at scale; and collaborate with the wider social care ecosystem.

Last updated on hub: 05 October 2020

Roma children’s participation: shaping responses to COVID-19 in the EU and Bulgaria

University of Central Lancashire

This policy paper presents research on the impact of COVID-19 of Roma children, including in the UK, and the barriers to their health and wellbeing and the potential of participatory responses. The findings are set in the current context of child poverty and related EU initiatives on poverty and participation. The findings show consistent patterns of challenging conditions experienced by some young Roma and their communities in relation to lack of essentials for basic health and income; wellbeing and education; discrimination and participation. Lessons to learned are highlighted and priority actions are recommended, including: improve supported and ethical mechanisms for hearing and responding to children’s views so that children share their opinions; community involvement in advocacy work; improvement of community-based services in terms of planning and service delivery; and improvement of intersectoral collaboration so that social, educational and health measures towards children and families are in line with specific needs and development opportunities in family context of the child.

Last updated on hub: 14 July 2020

Rough sleeping in England: looking beyond 'Everyone In'

St Mungo's

This briefing sets out the actions needed to reduce the impact of the Covid-19 crisis on people ability to find somewhere safe to stay and access the necessary support to rebuild their lives away from the street. At the beginning of the pandemic, the Government charged local authorities with getting ‘Everyone In’, and supporting everyone sleeping rough to move into self-contained accommodation. The paper highlights a number of key challenges that remain to be addressed, including: new people have continued to start sleeping rough during the pandemic; the risk of rough sleeping is increasing as a result of the impact of the lockdown on the economy; a high number of people currently in emergency accommodation will be unable to access ongoing support due to their migration status; difficulty finding move on accommodation due to affordability and access to the right support. To ensure the long-term safety of homeless people the paper recommends: ensuring everyone who is homeless is offered suitable emergency accommodation; suspending the Benefit Cap and lift Local Housing Allowance (LHA) rates in line with average rents; and suspending ‘no recourse’ rules that restrict access to support for non-UK nationals for at least the next 12 months.

Last updated on hub: 17 August 2020

Rural Wisdom evaluation: the value of connection

National Development Team for Inclusion

This short report shares the experiences and reflections of the Volunteering Matters Cymru team leading the Rural Wisdom project in Wales on the impact the COVID-19 pandemic has had upon their work. Rural Wisdom is a five-year National Lottery funded project exploring the impact of community-based activities that are led by older people living in rural areas in Scotland and Wales. In sharing these reflections, the report aims to provide others living and working in rural areas to apply and benefit from what works, in fast-paced and challenging times. For older people, the impact of the coronavirus pandemic has been incredibly detrimental. The issues identified, around loneliness, isolation and vulnerability, have been exacerbated by the measures to shield and isolate from family, friends and the wider community over a prolonged period of time. Building and maintaining connections with people, even remotely, has never been so important. Despite restrictions older people are still willing and able to contribute to their communities. Development Workers are working with people over the age of 70 who still volunteer but have adapted what they do based on their circumstances and restrictions, for example being a telephone befriender. Through engagement events, local community councils and steering groups, older people are still having a voice and influencing change; the difference is that they now meet online. Where groups or events have been sustained and taken on by the community the pandemic has only put a pause on their activity, although it is hard to tell how long for. However, other activities such as the school lunch club that had not been running long enough for it to be embedded or sustained, may need support to get re-started.

Last updated on hub: 07 December 2020

Safe and fair recruitment guide: COVID-19 supplement

Skills for Care

This COVID-19 supplement to SfC Safe and fair recruitment guide aims to help employers follow a clear process when recruiting social care workers, key staff and volunteers for eligible roles in connection with the provision of care and treatment of COVID-19 in England and Wales, or those being recruited to backfill roles because of the impact of the pandemic (COVID-19 roles). The guidance applies to all COVID-19 roles, particularly those where employers need staff to start work rapidly, and any undue delays to the recruitment, pre-employment vetting and onboarding process could lead to risks to the continuity of service; and the safety and wellbeing of other members of staff and the people using the service. The supplement has been developed in partnership with Dominic Headley & Associates and with input from the Disclosure and Barring Service (DBS) and the Care Quality Commission (CQC).

Last updated on hub: 29 June 2020

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