COVID-19 resources for managers and leaders

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590 people’s stories of leaving hospital during COVID-19

Healthwatch England

This report shines a light on people’s experiences of getting home from hospital during the pandemic. In March 2020, the Government introduced a new hospital discharge policy to help the NHS free up beds by getting people out of hospital quickly. This meant anyone who may need out-of-hospital support to help them recover would now have their needs assessed after being discharged (discharge to assess), rather than in hospital. The report drawn on a survey over 500 patients and carers and 47 in-depth interviews with health and care professionals involved in the hospital discharge process. Key findings include: 82% of respondents did not receive a follow-up visit and assessment at home and almost one in five of these reported an unmet care needs; some people felt their discharge was rushed, with around one in five feeling unprepared to leave hospital; over a third of people were not given a contact who they could get in touch with for further advice after discharge; overall patients and families were very positive about healthcare staff, praising their efforts during such a difficult time; around a third of people faced an issue with delayed COVID-19 test results. The research indicates the discharge to assess model could be beneficial for patients and staff if properly resourced and implemented. However, the high proportion of people who did not receive information about the changed process or an assessment from a health professional reveals that the approach set out in the policy remains in many places an ambition, rather than a reality. In the medium term this model also needs embedding within broader health and social care reforms.

Last updated on hub: 29 October 2020

Discharges from NHSScotland hospitals to care homes between 1 March and 31 May 2020

Public Health Scotland

This publication presents management information statistics on people aged 18 and over who were discharged from an NHS Scotland hospital to a care home between 1 March and 31 May 2020. The first section of this report describes the methods used to identify the 5,204 discharges of 4,807 adults to care homes and describes their characteristics and COVID-19 testing status during their hospital admission. The second section focuses on the adult care homes that individuals were discharged to. It describes laboratory-confirmed care home outbreaks of COVID-19 across Scotland where the first positive test occurred between 1 March and 21 June. It then examines associations between care home characteristics and COVID-19 outbreaks, including examining association between hospital discharge to care homes and outbreaks. The data shows that: 843 of the 1084 care homes received 5,191 discharges between 1 March and 31 May (13 of the discharges identified were to English care homes or the care home could not be identified); using laboratory confirmed cases, 348 (32%) of care homes experienced an outbreak of COVID-19; the percentage of care homes with an outbreak increased progressively with care home size; almost all outbreaks (336/348) occurred in care homes for older people; COVID-19 associated mortality was concentrated in its impact, more than half of COVID-19 deaths were in 64 homes and a quarter of all COVID-19 deaths were in just 25 homes; 13.5% of care homes with no discharges from hospital had an outbreak, compared to 38% of care homes with one or more discharges.

Last updated on hub: 29 October 2020

An avoidable crisis: the disproportionate impact of Covid-19 on Black, Asian and minority ethnic communities

Labour Party

A report of a review into how people from Black, Asian and minority ethnic backgrounds have been impacted by Covid-19. The pandemic is having a disproportionate and devastating impact on ethnic minority communities. Not only are Black, Asian and minority ethnic people dying at a disproportionate rate, they are also overexposed to the virus and more likely to suffer the economic consequences. The report argues that, despite repeated warnings, the Government has failed to take sufficient action. Covid-19 has thrived on inequalities that have long scarred British society. Black, Asian and minority ethnic people are more likely to work in frontline or shutdown sectors which have been overexposed to Covid-19, more likely to have co-morbidities which increase the risk of serious illness and more likely to face barriers to accessing healthcare. Black, Asian and minority ethnic people have also been subject to disgraceful racism as some have sought to blame different communities for the spread of the virus. The virus has exposed the devastating impact of structural racism. The report makes both immediate and long-term recommendations to protect those most at risk and tackle structural inequalities in several key areas including the machinery of government, health, employment and in the education system.

Last updated on hub: 28 October 2020

A child-centred recovery

Local Government Association

This document outlines ambitions for a child-centred post-Covid recovery, drawing together every aspect of policy and service delivery to create the places people want to live in and plan for the future. It outlines the immediate challenges as a result of the pandemic and what we need to do to tackle them; consider how councils and the Government can implement more child-centred approaches to policy and decision-making, to make sure that children are at the heart; and looks at the challenges we face in the longer-term to deliver the great places to grow up that children need and deserve. The report identifies three immediate priorities: a cross-Whitehall strategy that puts children and young people at the heart of recovery; investment in local safety nets and the universal and early help services, including mental health and wellbeing services, that children, young people and their families will need to support them through the short and long-term impacts of the pandemic; dedicated action to prevent the attainment gap from widening, including immediate work to stabilise the early years sector and support children and young people to attend school or to continue learning from home where required. The report argues that a child-centred recovery is about far more than services directly responsible for children and young people. Children deserve to grow up in good quality, stable homes, in safe areas offering positive long-term opportunities, with good access to the services they need.

Last updated on hub: 27 October 2020

Rapid review for care homes in relation to Covid-19 in Wales

Welsh Government

This rapid review aimed to ensure that the lessons from best practice are learned and shared by Local Authorities and Health Boards who were involved in working with care homes during the initial period of the Covid-19 pandemic in the spring and summer of 2020. The work for the review has included reading some research studies, reading many submitted reports by Health and Social Care leaders from Wales and a series of interviews with stakeholders including a number of Care Home managers and owners. The report includes sections summarising the context for care homes, the initial impact of the virus and the response, and the best practices that were found in helping care homes to address the pandemic. The final section draws together a set of considerations that health and social care partners could use to assist them in completing their action plans for the winter. The review highlights the importance for health and care to work in partnership with care home managers to ensure that: every care home has an effective Infection Control Plan that is put into place; every care home has an effective plan for business continuity that includes ensuring that there are staff available to meet residents’ needs; every care home should be supported to ensure there are meaningful and helpful day to day activities for residents and that the wellbeing of both staff and residents are taken into account in all the decisions that are made; every care home has the right protective equipment; every care home has access to tests for residents and staff to know who may have the virus; and every care home has good access to primary health services including GPs.

Last updated on hub: 27 October 2020

COVID-19 and care homes: update paper, 23 September 2020

This paper reviews the latest evidence on the transmission of Covid-19 in care homes. It focuses specifically on the relative risk of each of four routes of ingress of infection to the care home (hospital discharge, staff, visitor (professional or domestic) and community admissions) as well as the route of transmission within care homes once infection has entered, for which more detailed genomic studies are critical. Key findings include: although staff-to-staff transmission has been observed to have been a contributory factor in specific outbreaks, it is important not to generalise to all outbreaks and emphasise one route over another without clear evidence – studies undertaken so far indicate that multiple introductions are common; retrospective genomic analysis and seropositive studies in care homes find evidence for multiple routes of virus ingress to care homes, but are not systematic enough to quantify the relative frequency of different routes of ingress; evidence of staff to staff transmission has emerged in the genomic analysis (high confidence); weak evidence on hospital discharge and modelling the impact of visitors does not suggest a dominant causal link to outbreaks from these sources; public health measures that reduce community incidence could be effective in reducing ingress into care homes; asymptomatic or atypically symptomatic presentation in residents and staff mean that ingress may be hidden for a number of generations of disease; sequencing community tests to understand the comparator population is critical for the future.

Last updated on hub: 27 October 2020

The Government response to the Joint Committee on Human Rights reports on the detention of young people with learning disabilities and/or autism and the implications of the Government's COVID-19 response

Department of Health and Social Care

This is the Government’s formal response to the recommendations made by the Joint Committee on Human Rights in its report 'The detention of young people with learning disabilities and/or autism' published on 1 November 2019 and those made in its report 'Human Rights and the Government’s response to COVID-19: The detention of young people who are autistic and/or have learning disabilities' published on 12 June 2020. In the 2019 report the Committee concluded that young people’s human rights were being abused; that they were detained unlawfully contrary to their right to liberty, subjected to solitary confinement, more prone to self-harm and abuse and deprived of their right to respect for private and family life. The second report by the Committee concluded that as a result of the COVID-19 pandemic and resulting restrictions on visits, the temporary suspension of routine inspections, the likelihood of the increased use of restraint and solitary confinement and the vulnerability of those in detention to infection with COVID-19 (due to underlying health conditions and the infeasibility of social distancing) may add to, and further compound, the issues the Committee highlighted in its earlier report. In this document, the Government sets out its response to the Committee’s recommendations, including action already underway to ensure that people with a learning disability and autistic people receive the high-quality care and treatment we expect for everybody. Topics covered include: transforming care; ending harmful detention; the legal framework for detention; families as human rights defenders; conditions in places of detention; the Care Quality Commission; visits and the right to family life; use of restraint and solitary confinement; inspections; discharges; and data on COVID-19 infections and deaths.

Last updated on hub: 27 October 2020

Care homes action plan: summary of progress

Welsh Government

This document summarises the progress that has been made – and is being made – against the high-level actions in the Care Homes Action Plan. The Plan sets out high-level actions under six themes to ensure the care home sector in Wales is well supported ahead of winter pressures, learning lessons from the Covid-19 pandemic. The six themes are: infection prevention and control; personal Protective Equipment (PPE); general and clinical support for care homes; residents’ wellbeing; social care workers’ wellbeing; and financial sustainability.

Last updated on hub: 26 October 2020

Ethnic inequalities in Covid-19 are playing out again – how can we stop them?

Institute for Public Policy Research

This long read by IPPR and Runnymede Trust looks at how Covid-19 is set to continue to hit minority ethnic communities hardest as we enter the second wave. It proposes measures to help control the pandemic and mitigate immediate ethnic inequalities. including increasing access to treatment.

Last updated on hub: 26 October 2020

A rapid, multi-agency response to enhance care provider staff wellbeing and resilience during and post-lockdown

Research In Practice: Dartington

Isle of Wight’s Principle Social Worker, Simon Homes, discusses the rapid, cross-island response he and a new multi-disciplinary team implemented during the early stages of the coronavirus (COVID-19) outbreak, to increase care and support staff wellbeing and resilience when working during the pandemic.

Last updated on hub: 22 October 2020

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