COVID-19 resources

Results 491 - 500 of 1420

Deaths of people identified as having learning disabilities with COVID-19 in England in the spring of 2020

Public Health England

This review analyses the available data on the deaths from COVID-19 of people identified as having learning disabilities. The review looked at: deaths from COVID-19 of people with learning disabilities; factors impacting the risk of death from COVID-19 of people with learning disabilities; deaths in care settings of people with learning disabilities. The key finding of this study was that people with learning disabilities had significantly and substantially higher death rates in the first wave of COVID19 in England than the general population. Making no allowance for the younger age and different sex ratio of people with learning disabilities, the rate of deaths notified to LeDeR in this group was 2.3 times the death rate in the general population. If this figure is adjusted to allow for the likely level of under-notification to LeDeR it was 3.5 times the general population rate. After standardisation for age and sex the rate calculated just from notifications to LeDeR was 4.1 times the general population rate. Adjusting for the likely level of under-notification it was 6.3 times the general population rate. The total number of deaths in adults with learning disabilities for the 11 weeks from 21 March to 5 June was 2.2 times the average number for the corresponding period in the 2 previous years. By contrast, the number of deaths in the general population was 1.5 times the average for the 2 previous years. Deaths with COVID-19 in adults with learning disabilities were spread more widely across the age groups than those in the general population. As in the general population, the COVID-19 death rate in people with learning disabilities was higher for men than for women. The overall increase in deaths was also greater in Asian or Asian-British, and Black or Black-British people. Residential care homes providing care for people with learning disabilities do not appear to have had the very high rates of outbreaks of COVID-19 seen in homes providing care for other groups, mainly older people. This appears to be related to their smaller number of beds.

Last updated on hub: 16 November 2020

Deaths of people with learning disabilities from COVID-19

University of Bristol

This report describes the circumstances leading to death for a representative sample of 206 adults with learning disabilities. The majority of the 206 deaths (79%, n=163) were attributable to COVID-19: 27% of the total number of COVID-19 deaths notified to the LeDeR programme from 2nd March 2020 – 9th June 2020. Forty-three (21%) of the 206 deaths were attributed to other causes and are included as a comparator group – 6% of the total deaths from other causes occurring during this period. The study finds that there is a striking difference in age at death between COVID-19 deaths in the general population compared with people with learning disabilities. In the general population of England and Wales, 47% of deaths from COVID-19 were in people aged 85 years and over. Of all deaths of people with learning disabilities from COVID-19 notified to the LeDeR programme, just 4% were aged 85 years and over. A third (35%) of those who died from COVID-19 lived in residential care homes, rising to almost half of those with Down’s syndrome. A quarter (25%) lived in supported living settings. Priority must be given to supporting measures to prevent the spread of COVID-19 in these settings. People who died from COVID-19 were more frequently reported to have respiratory conditions (72%), compared to those who died from other conditions (60%). Access to healthcare that was problematic for some people who died from COVID-19 included: the responsiveness of NHS111; access to COVID-19 tests; and access to specialist learning disability nurses. Ensuring that these services are fully accessible to people with learning disabilities, their families and paid carers would improve service provision.

Last updated on hub: 16 November 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

Decision-making for receiving paid home care for dementia in the time of COVID-19: a qualitative study

BMC Geriatrics

Background: The lockdown imposed in the UK on the 23rd of March and associated public health measures of social distancing are likely to have had a great impact on care provision. The aim of this study was to explore the decision-making processes of continued paid home care support for dementia in the time of COVID-19. Methods: Unpaid carers caring for a person living with dementia (PLWD) who were accessing paid home care before COVID-19 and residing in the UK were eligible to take part. Participants were interviewed over the phone and asked about their experiences of using paid home care services before and since COVID-19, and their decision-making processes of accessing paid home care since the outbreak and public health restrictions. Results: Fifteen unpaid carers, who were also accessing paid care support for the PLWD before COVID-19, were included in the analysis. Thematic analysis identified three overarching themes: (1) Risk; (2) Making difficult choices and risk management; and (3) Implications for unpaid carers. Many unpaid carers decided to discontinue paid carers entering the home due to the risk of infection, resulting in unpaid carers having to pick up the care hours to support the person living with dementia. Conclusions: This is the first study to report on the impact of COVID-19 on paid home care changes in dementia. Findings raise implications for providing better Personal Protective Equipment for paid carers, and to support unpaid carers better in their roles, with the pandemic likely to stay in place for the foreseeable future.

Last updated on hub: 13 November 2020

Delirium: a missing piece in the COVID-19 pandemic puzzle

Age and Ageing

This editorial argues that delirium is an important missing component in the assessment and management of older people for COVID-19. Guidelines should include delirium as a presenting feature, screening should be a standard of care, and non-pharmacological approaches for delirium prevention and management need to be implemented as early and often as possible. Resources to assist healthcare providers should be built into electronic medical records, order sets and protocols. Key points raised in this paper include: older people are most vulnerable to severe COVID-19 infections and mortality; current guidance for diagnosis does not routinely include delirium, which may lead to under-detection of COVID-19; the care home population is particularly at risk, as failure to promptly detect COVID-19 may lead to outbreaks; non-pharmacological approaches to management of delirium may be more difficult to implement but remain the priority.

Last updated on hub: 18 August 2020

Delivering a Coronavirus recovery that works for children: summary and recommendations

The Children's Society

This briefing sets out an approach to delivering a recovery from the impact of COVID-19 that works for all children. Such an approach is underpinned by a set of principles, including taking an integrated and holistic approach, promoting children’s rights and entitlements, treating children as partners, reducing inequalities, committing to a comprehensive, long-term funding settlement, responding to the changed needs, investing in the workforce, adopting relationship-based, person-centred models of care. Experts from across the children’s sector have been working closely together to produce a set of briefings summarised in this paper. These briefings build on these principles to begin to set out an approach to delivering a recovery which works for children across six key areas: child poverty and social security; mental health and wellbeing; early years recovery; supporting children in care and care leavers; safeguarding and child protection; and school returns.

Last updated on hub: 29 July 2020

Delivering a recovery that works for children: full list of recommendations

The Children's Society

This briefing sets out a comprehensive set of recommendations to ensure recovery plans from Covid-19 work for all children and young people. Drawn up and endorsed by a number of leading children’s sector organisations, the recommendations support a vision that considers the needs of children, young people and their families in the round, from conception to age 25; puts their voices at the heart of the recovery process; and is committed to investing in the services and workforce that they rely on. The recommendations consider both the short and the long-term, focusing on child poverty and social security; mental health and wellbeing; early years recovery; school returns; children in care; keeping children safe; and the overarching principles for recovery.

Last updated on hub: 29 July 2020

Delivering care at home and housing support services during the COVID-19 pandemic: Care Inspectorate inquiry into decision making and partnership working

Care Inspectorate Scotland

This report draws together the views of health and social care partnerships and service providers in Scotland about their experience of care at home and housing support services during the first phase of this pandemic. It sets out the findings of a Care Inspectorate’s inquiry which investigated how these services were prioritised to help ensure service delivery continuity; what were the known impacts on people who experience care; how the risks to service delivery were mitigated; how effective were the partnership working arrangements; and what were the recovery plans for services. The inquiry found that the most robust responses to the challenges and uncertainties of the pandemic involved an integrated approach and included: targeting resources to meet gaps and pressures as they occurred and reviewing and refining approaches as new information came to light; maintaining a focus on how staff remained confident, safe and secure by addressing the challenges of PPE, guidance and testing; responding quickly with additional financial support and guarantees to ensure services remained viable and that the commitment was not undermined by unpredictable reductions in income and additional costs; investing in staff terms and conditions to reduce disincentives to testing and self-isolating when required; and working together across health and social care, service providers and the community.

Last updated on hub: 30 September 2020

Delivering core NHS and care services during the pandemic and beyond: second report of session 2019–21

UK Parliament

Findings of an inquiry to investigate a range of issues relating to the delivery of core NHS and care services during the pandemic. This report addresses the following issues: communication with patients; managing waiting times and the backlog of appointments; issues facing NHS and care staff relating to access to personal protective equipment (PPE) and routine testing of staff; issues facing NHS and care staff relating to workforce “burnout”; and what lessons can be learnt from the pandemic in order to support the NHS in the future. The coronavirus pandemic posed an unprecedented challenge to the NHS and social care system. The report raises concerns about the lack of effective communication strategies with patients; the substantial increase in the number of missed, delayed and cancelled appointments across critical non-COVID services; and the effect of the pandemic on the physical and mental wellbeing of the NHS and social care workforce. The report also assesses what changes should take place to support the NHS in the long-term. They include introducing an expanded 111 dial service to support A&E departments, investigating how technology (“telemedicine”) can be used without digitally excluding those already disadvantaged, and retaining capacity and resources from the independent sector in the long term.

Last updated on hub: 05 October 2020

Delivering good practice initial assessments of family and friends carers in the context of Covid-19. An appendix to the Initial family and friends care assessment: a good practice guide

Family Rights Group

The Initial Family and Friends Care Assessment: A good practice guide is designed to be used by local authorities to support decision making as to whether a family member or friend might be a potentially realistic option to be a carer for a child who cannot live safely with their parents. It sets out the key issues to be addressed in the very early stages of identifying potential carers. However, delivering good practice in the current circumstances is challenging in several ways: social workers contact with, and assessments of, potential carers may need to be through phone and virtual means; potential carers may be having to cope with a range of challenges resulting from Covid-19 as well as the impact of the crisis in their family that has resulted in a child or children needing long term care from a family member; family members who might be suitable may not be in a position to offer immediate care because of the health risks they are dealing with; family members may be dealing with a number of serious questions about their future because of the broad uncertainties resulting from the pandemic. The purpose of this short document is to assist practitioners in these unique circumstances to produce a robust and balanced assessment which is appropriately child and family centred and which can support sound decision-making.

Last updated on hub: 18 January 2021