COVID-19 resources

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What now for social care?

ARK

This brief paper paints a picture of social care systems and the workforce struggling to cope under significant pressure as a result of the COVID 19 pandemic. It argues that many of the now highly visible problems relating to social care are not new; the pandemic has just brought to public attention serious problems resulting from years of under-funding and political neglect. Even in Northern Ireland where health and social care provision has been structurally integrated since 1973, a clear fault line exists between universal health services and means tested social care. There are inequities driven by how services are funded, how needs are assessed, how individual contributions are assessed, the fragmentation of the provider market and variation in care standards and quality. The paper focuses specifically on the fragmented provision and variable standards; the social care workforce; and the integration of health and social care in Northern Ireland. It observes that the experience of NI has shown clearly that structural integration does not in itself lead to parity between health and social services. That can only be achieved by reform of the funding and delivery of social care.

Last updated on hub: 08 September 2020

Decision making in a crisis: first responses to the coronavirus pandemic

Institute for Government

This report examines the government’s initial response to the Covid-19 crisis, including the implications for the social care sector and workforce, and the decisions made in three areas: economic support, Covid-19 testing and the lockdown. It suggests that the response was hampered by the absence of a long-term strategy, lack of clarity about who was responsible for what and its poor use of evidence. The report also identifies how: the government needed to be clearer about the role of science advice and its limitations, particularly in the early stages of the crisis when it looked to its scientists to generate policy, not just advise on it; government decisions were influenced too much by concerns over NHS capacity rather than by controlling the spread of the virus; senior officials distanced themselves from the decision to reach 100,000 tests a day, and it was unclear who was responsible for different aspects of the testing regime, which made it difficult to assign responsibility for remedying gaps and failures; the government did not think about some of the most important aspects of how it would implement its policies until after it had announced them, leaving many public services, in particular schools and the police, playing catch up.

Last updated on hub: 08 September 2020

Deprivation of Liberty Safeguards: annual monitoring report for health and social care 2018-19

Care Inspectorate Wales

This is the annual monitoring report of Care Inspectorate Wales and Healthcare Inspectorate Wales on the implementation of Deprivation of Liberty Safeguards (DoLS) in Wales. The findings show that the total volume of applications received by local authorities increased by 6% in 2018-19 - however, for health boards, the number of applications has remained relatively stable for the last two years; roughly three quarters of applications sent to health boards are for urgent authorisations; the majority of DoLS applications are for individuals who are aged 65 or older; the vast majority of the applications that were refused were on the grounds of mental capacity – the authoriser required further evidence that the person lacked the mental capacity to make the decision in question before the DoLS application was accepted; most standard applications were not completed in 28 days – supervisory bodies are unable to assure themselves that people’s human rights are not being breached by being deprived of their liberty unlawfully; very few people were referred to Independent Mental Capacity Advocates (IMCAs) or referred to the Court of Protection.

Last updated on hub: 08 September 2020

What does the impact of Covid in social care mean for the NHS? 5 questions, 10 actions

iMPOWER

Based on findings from interviews with directors of adult social services, this paper focuses on five critical areas that will set the direction for social care to bounce forward from the Covid-19 crisis. These are: structural integration and a national funding solution; the right balance between acute hospitals and local communities; re-shaping the provider market; developing enabled, embedded, multidisciplinary work across pathways; and a paradigm shift in the value and importance of social care. The paper identifies ten actions, setting out practical steps that support going beyond recovery through winter and into next year – to drive an inclusive vision for health and care systems. These include: assure the adult social care financial position is accurate in system models before the end of summer and reviewed through autumn; ensure there is dedicated agenda time on key pressures for local government; identify named neighbourhood change leads and encourage them to collate and share barriers to delivery; invest time in understanding the true baseline for local people plans; support health and care colleagues to undertake case reviews so that the Covid-related change to demand is evidenced; ensure VCS representatives are present at discussions on the design of new models of care; work with public health colleagues to ensure delivery is based on behavioural science; set clear joint expectations of how colleagues will work and make decisions at an ICS level; understand what is working, and what could work even better by having a named evidence lead; and build a bottom-up change plan, not a top-down one. These actions sit under a broader checklist, included in this paper, to assess how well systems are partnering at the moment.

Last updated on hub: 08 September 2020

Leave no-one behind: action for an age-friendly recovery

Older People's Commissioner for Wales

Drawing on evidence from 16 engagement sessions held with older people and those who work with and support them across Wales, this report considers what, in the wake of Covid-19, an age-friendly recovery may look like, setting out both short- and longer-term actions. The Covid-19 crisis has laid bare the systemic inequalities and discrimination that exist – especially the disproportionate impact that the pandemic has had on particular groups, such as people from BAME communities. It has also revealed the ageism that exists in societies and the devastating consequences that can flow from this. The report explores the aspects and implications of an age-friendly recovery in relation to: social care and health services in Wales; the economy and older people; stopping the abuse of older people; strengthening communities; and improving communication and inclusion. With specific reference to social care and health service, the long-term actions identified in this report include: establish a major healthy ageing programme focused on supporting older people and helping people to age well; expedite work to reform social care funding and ensure long-term investment in the social care sector; improve engagement with older people in the development of services; appoint a Chief Social Care Officer in the Welsh Government to act as the head of the profession in Wales; and conduct a review of spending on social care to determine whether the allocation of social care resources is age discriminatory, and take action on the findings.

Last updated on hub: 08 September 2020

Digital innovation in adult social care: how we've been supporting communities during COVID-19

This report is intended to share learning and offer practical considerations for councils, their partners and national bodies on how best to support greater digital innovation and adoption across the adult social care sector. It draws on engagement with councils both before and during the adult social care COVID-19 initial response. It looks at what local authorities have done to support the use of technology for connection, wellbeing and bringing communities closer together; it assesses what we have learned about the factors which lead to successful digital; and considers what next if we want to keep up the momentum and sustain new learning, approaches and ways of working. Findings are grouped into the following four themes, although these are not mutually exclusive and are enablers of each other: promoting wellbeing and independence; flexible and enabled working; digital for everyone; and working together with partners. The report finds that local authorities made greater use of technology to help people of all ages and in all settings get connected and stay connected, independent and well; they adopted digital technology to keep vital services up and collaborated with others to adopt digital technology at pace and scale. Key lessons and messages include: simple technologies can help people with daily activities and reduce isolation; digital transformation requires strong leadership and a culture shift; it’s not just about the kit, but about enabling outcomes for people and communities; and sustainable and meaningful change needs strong partnerships and commitment. To sustain the momentum, the report recommends using technology preventatively to support self-management; investing in people to achieve digital change and transformation; investing in local and co-produced digital approaches; and investing in digital to support longer-term adult social care reform which is coproduced with key stakeholders and communities.

Last updated on hub: 07 September 2020

The rapid learning initiative into the transmission of COVID-19 into and within care homes in Northern Ireland

Northern Ireland. Department of Health

This report provides the findings of the Rapid Learning Initiative with regards to the transmission of Covid-19 into and within care homes during the first surge of the pandemic, and makes recommendations on the way forward prior to further potential surges of infection. It details the findings of each of the four sub-groups, which considered: the experience of residents, families and staff; symptom monitoring, interventions and testing; infection prevention and control; and physical distancing, reduced footfall and restricted visiting. The initiative identified three overarching structures and processes that will need to be established to support the delivery of outcomes and bring about a learning system that works across Heath and Social Care (HSCNI), including the independent sector and Trusts: at strategic level, the collaborative partnerships established for the purposes of the Initiative should continue and develop further to support future development of Strategy and Policy; a regional learning system should be developed and include key quality indicators for Care Homes (led by frontline staff) using real-time data that can for continuous improvement; and a quality improvement learning system should include building the capability and capacity within Care Home staff to use continuous improvement methodologies to implement operational improvement as a system.

Last updated on hub: 07 September 2020

COVID-19 Nursing Homes Expert Panel: examination of measures to 2021: report to the Minister for Health

Department of Health (Ireland)

This report provides a summary of the work conducted by the Nursing Homes Expert Panel, looking at the effectiveness and appropriateness of both national and international protective public health and other measures adopted to safeguard residents in nursing homes, in light of COVID-19. The evidence-informed and consultative approach taken by the Panel is described in Chapter 2. Chapter 3 presents an overview of relevant epidemiological information and data. Chapter 4 presents a summary and the results of a systematic evidence review completed under the direction of the Panel. Chapter 5 gives an overview of the results of a three-part consultation process conducted by the Expert Panel. Chapter 6 sets out the views and considerations of the Panel in respect of healthcare policy for older persons, and finally, Chapter 7 sets out the in-depth discussion on learning and the recommendations of the Panel. These address a number of thematic areas, including: public health measures; infection prevention and control; outbreak management; future admissions to nursing homes; nursing home management; . data analysis; community support teams; clinical – general practitioner lead roles on community support teams and in nursing homes; nursing home staffing/workforce; education-discipline-specific and inter-disciplinary; palliative care; visitors to nursing homes; and communication.

Last updated on hub: 07 September 2020

COVID-19: guidance for commissioners and providers of hostel services for people experiencing homelessness and rough sleeping

Public Health England

Information on coronavirus (COVID-19) for commissioners and providers of hostel services for people experiencing homelessness and rough sleeping. The guidance covers: hostels with individual self-contained rooms with en-suite facilities that have shared kitchens; and hostels without individual self-contained rooms and that have communal facilities. This guidance does not cover night shelters. [Published 16 March 2020; Last updated 3 September 2020]

Last updated on hub: 07 September 2020

Social care: time to grasp the nettle

NHS Confederation

This report, part of the NHS Reset campaign, explores the opportunities and challenges ahead for health and social care. The COVID-19 pandemic has highlighted the critical role that social care plays in the delivery of health and care services. But it has also exacerbated the underlying weaknesses in social care and demonstrated the need for fundamental reform. The report argues that four critical factors are needed to reset social care: a stable, well-funded social care service – without social care reform leading to a sustainable system the NHS will not be able to deliver high-quality care in the wake of the pandemic; a long-term plan for social care to address the imbalance that was already present in the social care service, as well as a fundamental review of the model of social care provided in England; a well-resourced and trained workforce – a national, integrated health and care workforce strategy would go some way to tackle the crippling workforce issues facing social care; and outcome-based commissioning – the NHS needs a joined-up approach to commissioning, with people at the forefront of local decisions.

Last updated on hub: 07 September 2020