COVID-19 resources

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Fixing social care: better quality services and jobs

Trades Union Congress

This report looks at how a better social care system can be built in the wake of the Covid-19 crisis. The structural problems in the sector have been thrown into sharp focus during the pandemic. At the same time, the pandemic has also shown how essential social care is to the fabric of society. The report looks at what has gone wrong in terms of funding, workforce, and provider market, calling for long-term, sustainable funding of services that provides value for money to the public purse while meeting the needs of individuals and communities; and supporting care workers through decent pay and working conditions. To achieve this, the report recommends: a new funding settlement to meet rising demand and improve pay and conditions for staff; immediate funding to fill all social care vacancies – in a time of rising unemployment, social care could provide a steady source of new decent jobs; fair pay and conditions for care workers, including a sector minimum wage of at least £10 per hour and an end to the zero-hours contracts, and poor or non-existent sick pay; a national Social Care Forum to bring together government, unions, employers, commissioners and providers to coordinate the delivery and development of services, including the negotiation of a workforce strategy; a reduced private sector role; and a universal service free at the point of use, paid for through general taxation to ensure high-quality social care can be quickly accessed by everyone who needs it, in every part of England, without any variation in cost and qualifying rules.

Last updated on hub: 14 September 2020

Flexible responses during the Coronavirus crisis: rapid evidence gathering

Cordis Bright

This report presents findings from a rapid gathering of evidence in relation to the responses to the Covid-19 pandemic by local services and systems supporting people experiencing multiple disadvantage across England. For many people facing multiple disadvantage a series of variations were put in place over this period in the support available to them, including in substance misuse services, criminal justice, homelessness and housing services, mental health services, and support for women. This rapid research sought to understand and document the types of changes, adaptations and flexibilities that have been introduced; how those decisions were reached and who was involved; the impact the changes are having on local services and systems and people facing multiple disadvantage; and what local areas are doing to evidence these changes. The study finds that positive impacts of the changes and flexibilities introduced include: clients adapting and engaging well; safe and sustained accommodation placements for rough sleepers; increased client autonomy; increased trust in individuals and services; increased engagement with substance misuse services; effective self-management of medication; positive mental health outcomes for some people where additional and appropriate support is available. The report also examines the negative impacts that local responses had on users of services, which include: social isolation, anxiety and poor mental health; people experienced ‘knock back’ to progress and improvement in outcomes prior to the crisis; loss of meaningful activity; less positive experiences of emergency accommodation; challenges of engaging in remote support; exclusion of vulnerable people who are not “verified” as rough sleeping.

Last updated on hub: 25 June 2020

Flipping social care: stepping into the unknown

Association of Directors of Adult Social Services

This briefing considers how social care can be seen as an investment in communities and not just as an unavoidable cost to society. The principle of ‘flipping social care’, which is the focus of the paper, is about recognising and valuing the economic benefits and opportunities that flow from a vibrant and well-resourced social care sector. Whilst acknowledging that Covid-19 has challenged the sector in countless ways, the paper suggests that the case for the sector as a driver for economic prosperity remains intact, and it is arguably stronger than before. The sector has long been wrestling with the fact that the solutions and approaches to health and care that are used today are unlikely to be sustainable as demand continues to grow – the pandemic is magnifying the challenge and accelerating the urgency with which this must be met. The paper sets out how the ‘flipping social care’ principle can be realised through a vision for adult social care in the West Midlands. This entails putting justice for the most vulnerable and marginalised citizens at the centre; ensuring decisions about local areas are entrusted to the people who live and work locally, have a track record and know what their communities need; delivering truly-integrated working across social care and health services; building a strong case for intelligent public investment in social care as a driver for economic prosperity as well as social wellbeing; moving away from offering care from buildings to planning support around a person’s strengths and needs; using data and technology to understand what people need and how to target help and support more effectively; and designing a new and better way to ensure social care staff are paid fairly for what they do and can work in a healthy, supported and flexible way.

Last updated on hub: 28 July 2020

Foregrounding the perspectives of mental health services users during the COVID-19 pandemic

Mental Health and Social Inclusion

Purpose: This paper aims to highlight the critical importance of the perspectives of mental health service-users during the COVID-19 pandemic. Design/methodology/approach: This viewpoint is based on a review of recent research and literature and draws on consultations with experts by experience, including the lead author. Findings: The authors argue that expertise-by-experience is critical to policy, service development and research; but there is a risk it will be neglected at a time of rapid and reactive clinical development. Research limitations/implications: Understanding and responding to the nuances of individual need can only be achieved through coproducing service strategy design, delivery and research with mental health service users. The consultation outlined in this viewpoint gives some indication of the type of valuable insights that can be gained through seeking and listening to the perspectives of experts by experience. Originality/value: The discussions revealed that experience of managing severe and complex mental health conditions can actually be advantageous when facing a crisis such as COVID-19.

Last updated on hub: 19 November 2020

Frailty in the face of COVID-19

Age and Ageing

Rapidly increasing healthcare demand due to COVID-19 requires clinicians to make difficult medical and ethical decisions about the treatment of older people, models of care and triage systems. Algorithms and scoring systems are being developed to predict risks of mortality in relation to the most limited resources such as mechanical ventilation. Screening of frailty is being proposed as a key tool to assist in this triage process. This commentary argues against the use of screening tools (including the Clinical Frailty Scale (CFS) when used as such) as the sole component to ration access of older people to health care. Instead it recommends that frailty screening tools are implemented as a rapid component of a person-centred approach to assessment that takes account of three key biomedical factors: severity of the presenting acute illness, the likelihood of medical interventions being successful and the degree of frailty. Key points raised in this paper include: the Clinical Frailty Scale is a quick and reliable screening tool for frailty; while the CFS has value in allocation of scarce health resources, it also has limitations; frailty is a continuum rather than a dichotomous variable; the type and severity of the presenting illness are important variables independently associated with the clinical outcome; a person-centred approach should consider the severity of illness and likelihood of success as well as the degree of frailty.

Last updated on hub: 18 August 2020

Free webinar series - supporting survivors during COVID-19

Solace

Solace have developed a series of 4 webinars to share expertise and best practice from across the sector, to help professionals across the UK better understand how they can continue to provide support to survivors. The webinar titles include: Understanding domestic abuse in the context of COVID-19; Assessing risk during COVID-19; Safety planning during COVID-19; Supporting survivors to flee during COVID-19.

Last updated on hub: 08 June 2020

Free wellbeing resources for care homes

Oomph! Wellness

Oomph! are keen to support care homes across the UK with stimulating, fresh and varied content to ensure that residents are engaged during this time when they might be feeling disconnected from their friends, families and the outside world.

Last updated on hub: 09 June 2020

From crisis to coordination: challenges and opportunities for integrated care posed by the COVID-19 pandemic

International Journal of Integrated Care

Editorial. Suggests that our response to the COVID-19 pandemic is hampered by the lack of essential data and knowledge. Any thorough analysis of the policies and their consequences will not be possible for some time to come. Suggests that the only thing we can say with certainty is that COVID-19 has demonstrated the shortcomings of our health and social systems, shortcomings exacerbated by political inertia in addressing complex societal challenges through population-based approaches. The article also points to three persistent and well-known challenges which now need addressing. These include that, responses to COVID-19 have largely NOT been integrated, leading to adverse outcomes; responses continue to demonstrate inequalities in care and outcomes to vulnerable populations; and the need to build evidence for an integrated and coordinated response, and to inform and drive policy and practice. The editorial concludes that COVID-19 has accentuated the stark reality that, despite the efforts of the past 20 years, there remains a continued failure to embrace integrated care systems. It has also demonstrated how quickly systems, organisations and individuals can change, if they must.

Last updated on hub: 12 October 2020

From crisis to opportunity? Innovations in Australian social work field education during the COVID-19 global pandemic

Social Work Education (The International Journal)

In the context of the COVID-19 pandemic, Australian universities have had to radically rethink and reconfigure many aspects of social work education. This has been particularly pronounced for field education, as human service organizations that ordinarily host student placements have also needed to rapidly design remote modes of service delivery in the context of current social distancing requirements, and unprecedented demands for assistance. Prior to COVID-19, a growing body of literature had emerged, mounting concerns about the current Australian model of field education. During the pandemic, the Australian Association of Social Workers (AASW) has modified some of the standards related to field education. Such variations are entirely necessary in the context of the pandemic and create opportunities for social work educators, not only to imagine new models of field education that are more suitable for contemporary contexts but to implement and trial them in ways that have not been possible until now. This paper largely focuses on innovations in field education that are currently being developed and implemented at Queensland University of Technology (QUT), in Australia.

Last updated on hub: 12 November 2020

From ovid to COVID: the metamorphosis of advanced decisions to refuse treatment into a safeguarding issue

Journal of Adult Protection

Purpose: This paper aims to examine advance decisions to refuse treatment (ADRTs) in the context of the COVID-19 (Coronavirus 2019) pandemic. This study considers the development of ADRTs, the lack of take up and confusion among the general public, clinicians and health and social care staff. Design/methodology/approach: The paper is a conceptual piece that reflects on ADRTs in the particular context of COVID-19. It considers professional concerns and pronouncements on ADRTs. Findings: ADRTs have a low take up currently. There is misunderstanding among public and professionals. There is a need for raising awareness, developing practice and a need to allay fears of misuse and abuse of ADRTs in clinical, health and social care settings. Practical implications: The authors make recommendations that reflexive training and awareness become the norm in health and social care, that reform of ADRTs is undertaken to prevent misunderstandings and that the person becomes central in all decision-making processes. Originality/value: This paper is original in considering ADRTs as a safeguarding issue from two perspectives: that of the person making the ADRT and being confident in respect for the decisions made; and that of clinicians and other professionals being reflexively aware of the need to accept advance decisions and not acting according to unconscious biases in times of crisis.

Last updated on hub: 09 December 2020