COVID-19 resources

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Winter discharges: designated settings

Department of Health and Social Care

This letter sets out: an overview of the requirement for designated care settings for people discharged from hospital who have a COVID-19 positive status; and an instruction for local authorities to commence identifying and notifying the Care Quality Commission (CQC) of sufficient local designated accommodation and to work with CQC to assure their compliance with the infection prevention control (IPC) protocol. [First published 21 October 2020. Updated 13 November 2020, Added the letter 'Designated settings requirements: FAQs']

Last updated on hub: 22 October 2020

Connecting services, transforming lives: the benefits of technology-enabled care services

Public Policy Projects

This report explores how technology-enabled care services (TECS) can be used for the benefit of patients, carers and the health and care sector, and makes recommendations about how the UK can be at the forefront of use of TECS, particularly in an era of Covid-19. Section 1 establishes the types of TECS, including telehealth, telecare, telemedicine, and assistive technologies. TECS operate at a range of levels, from reactively responding to users’ needs through to predictive technologies which can identify an incident before it occurs. Section 2 explores how TECS are currently used in the UK, including the citizens’ appetite for such technology. It also quantifies the market potential of TECS and the Government’s policy towards these interventions. Section 3 categorises TECS into five types of service provision: teleconsultation, teletriage, telemonitoring, reminder technology and assistive technologies, and explains how each can be used. Section 4 highlights the benefits of embracing TECS, including improved patient experiences, better health outcomes, improved staff/carer experiences and lower cost of care. Section 5 explores TECS in the devolved nations. Section 6 looks at TECS internationally. Section 7 considers TECS in the era of Covid-19, and how the rapid adoption of some TECS as a result of the pandemic should be embedded into routine service offerings in the future. Section 8 highlights the barriers to uptake of TECS in the UK. Section 9 sets out what needs to be done to achieve the potential of TECS and makes recommendations, including calling for Government support to enable all health and care providers to achieve a minimum technology standard.

Last updated on hub: 22 October 2020

Exploring the strength of community: how to promote wellbeing for all citizens: a discussion paper from the Centre for Welfare Reform

Centre for Welfare Reform

This discussion paper explores ways to maintain and consolidate the strength of community – as it emerged and gained traction during the coronavirus pandemic – as a long-term alternative to the broken and inefficient welfare systems we currently have in place. The Covid-19 outbreak in the UK in February 2020 triggered an accelerated movement of community resilience – the like of which has not been seen since World War 2. The paper explores the changes – some subtle and some more radical – which could help to shape a fair, equal and better society: changes to government policy; changes to systems and structures; radical change (an upside-down picture of society and the devolution of power to communities). The paper argues that there is an opportunity to make changes to a system which is no longer fit for purpose and to use resources in a far more efficient way by strengthening communities and placing power and resources into their hands. Rather than going directly to the corporate provider marketplace for solutions, there is a real opportunity for third sector and community-based organisations to offer local, creative and deeply rooted solutions by working directly alongside communities where they are based; and where strong relationships and connections exist.

Last updated on hub: 21 October 2020

Caring behind closed doors: six months on: the continued impact of the coronavirus (COVID-19) pandemic on unpaid carers

Carers UK

Findings of the second wave of an online survey of carers, carried out in September 2020, to explore the impact the pandemic is having on carers' lives and their worries for the future. A total of 5,904 carers and former carers responded to the survey. This included 5,583 current carers and 321 former carers. The findings show that while in April 2020 70% of carers were providing more care as a consequence of the crisis, six months later this has increased further; 81% of carers reported that they were providing more care since the start of the outbreak for one or more reasons. Eight out of ten carers said the needs of the person they care for have increased since the pandemic; two thirds have not been able to take any breaks from their caring role during the crisis; almost two thirds say that their mental health has worsened; and three quarters of carers are feeling exhausted and worn out from caring during the pandemic. The report concludes with a series of short, medium and longer-term recommendations for UK and National Government.

Last updated on hub: 21 October 2020

The predictable crisis: why Covid-19 has hit Scotland’s care homes so hard

Common Weal

This paper considers how government in Scotland has managed the Covid-19 crisis, using what has happened at Home Farm Care Home on Skye to illustrate the issues but also, potentially, to point to the way forwards. It argues that much of the Covid-19 disaster in care homes was quite predictable and, as such, represents a failure by both care home providers and the public authorities. It then looks at these failures within the broader context of the development of the care home sector in the last 27 years, with a particular focus on how this has provided for the health of older people. It concludes with some recommendations, both for immediate action and for more fundamental reform of the sector and the role of public authorities within it. Key points include: based on quality ratings at the outset of the crisis more than one quarter of Scotland's care homes (those rated adequate or below) could have been expected to be unable properly to protect older people in the event of a pandemic; the Care Inspectorate, which has few enforcement powers, was incapable of brining care homes up to the standard required by the Covid crisis; the result is that six out of ten care homes in Scotland have had a case of Covid and about 45 per cent still have a current case (as of Monday 18 May); for the first eight weeks of the crisis the Scottish Government was adamant that the providers (and not the Scottish Government) were responsible for protecting care home residents – this effectively represented the privatisation of the responsibility for older people in care during the crisis and restricted adequate access to medical treatment; the repeated updating of guidelines created a confusing impact.

Last updated on hub: 21 October 2020

How coronavirus has affected equality and human rights

Equality and Human Rights Commission

This report outlines the currently known key impacts of the coronavirus (COVID-19) pandemic on equality and human rights across key areas of life, including work, poverty, education, social care, and justice and personal security; and the risks faced by different groups. Key findings include: the economic impact of the pandemic has been unequal, entrenching existing inequalities and widening others; the groups most likely to be affected by the expected rise in poverty include young people, ethnic minorities, and disabled people, who are already closest to the poverty line; older people, ethnic minorities and some disabled people, particularly those in care homes, have been disproportionately impacted by the pandemic; the increased demand for social care has threatened the financial resilience of the sector, potentially impacting its users and workers; this has led to an increased reliance on unpaid carers, who are more likely to be women; there has been a rise in reported domestic abuse and there are concerns about the ability of survivors to access justice.

Last updated on hub: 21 October 2020

The impact of COVID-19 to date on older people’s mental and physical health

Age UK

This briefing presents findings of a study on the impact of the pandemic on older people’s physical and mental health. It is based on 569 responses to a survey – 369 respondents were older people themselves and 200 answered on behalf of an older person; and representative online polling of 1,364 people over the age of 60 – of these nearly half were over the age of 70 and 40% were already living with a long-term condition before the start of the COVID-19 pandemic. The briefing focuses on the impact of the pandemic on physical health; diet and nutrition; cognitive decline; people affected by dementia; long term conditions and shielding; mental health and wellbeing; self-neglect; bereavement; loneliness; and health inequalities. While some older people have used the last few months as an opportunity to do more exercise and improve their fitness, this study suggests that many have seen their health deteriorate in the face of isolation and reduced opportunities to socialise and be physically active – sometimes drastically so. The pandemic has taken its toll on older people’s mental health. Older people with pre-existing mental health conditions have seen an increase in the severity of their symptoms, while others are struggling for the first time. Clubs, activities, and volunteering, which older people previously were involved with have been put on hold, while friends and family have needed to stay away, leaving many older people feeling lonely and isolated. Critically, older people from more disadvantaged socioeconomic backgrounds have been more severely affected, both mentally and physically.

Last updated on hub: 21 October 2020

Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020

The Office for National Statistics

Updated estimates of mortality involving the Covid-19 by ethnic group and investigation of the explanatory power of hospital-based comorbidity on ethnic differences, building on previous models published by the Office for National Statistics. Considering deaths up to 28 July 2020, males and females of Black and South Asian ethnic background were shown to have increased risks of death involving the Covid-19 compared with those of White ethnic background. In England and Wales, males of Black African ethnic background had the highest rate of death involving COVID-19, 2.7 times higher than males of White ethnic background; females of Black Caribbean ethnic background had the highest rate, 2.0 times higher than females of White ethnic background. All ethnic minority groups other than Chinese had a higher rate than the White ethnic population for both males and females. Looking separately at the care home population, males of Asian ethnic background and females of Black and Asian ethnic backgrounds (using broader ethnic groupings) also had a raised rate of death involving COVID-19 compared with people of White ethnic background after taking account of geography and health measures. These findings show that ethnic differences in mortality involving COVID-19 are most strongly associated with demographic and socio-economic factors, such as place of residence and occupational exposures, and cannot be explained by pre-existing health conditions using hospital data or self-reported health status.

Last updated on hub: 21 October 2020

Valuing voices: protecting rights through the pandemic and beyond

VoiceAbility

This report offers insight into the challenges people face having their rights upheld and being listened to during the Covid-19 pandemic. These challenges are not always new but have been exacerbated by the restrictions in response to the coronavirus pandemic. The report brings together findings from a survey of 435 advocates working across England and Wales that was carried out in June 2020. Advocates shared urgent concerns which reflect not only the restrictions that the pandemic brought but also the wider attitudes towards people who have additional support needs. The right to advocacy remained unchanged by the Coronavirus Act and restrictions enacted by government. However, the survey findings suggest that while for some people this meant good support continued, for others the restrictions meant they could not get the support they needed, when they needed it – three quarters (76%) of advocates felt the human rights of the people they support were not being fully upheld. Nearly a third (31%) of advocates had seen Do Not Attempt Cardio Pulmonary Resuscitation orders (DNACPRs) being placed on the people they support without regard to the person’s feelings, wishes, values or beliefs, and without formal capacity assessments or consultation with family. One in five reported that people were being blanketly denied healthcare. Over a quarter of advocates experienced a care provider trying to prevent access to advocacy. Advocates also highlighted a lack of care planning, discharge planning, and support. The report sets out concrete recommendations for government, health and social care providers and local authorities, calling for a culture change and a reinvigorated focus on human rights that recognises individual choice and control.

Last updated on hub: 21 October 2020

COVID-19: information and guidance for care home settings (adults and older people)

Health Protection Scotland

This guidance for care homes provides advice about COVID-19 for those working in care home settings for adults and older people. It covers: measures to prevent spread of COVID-19 and protect people at increased risk of severe illness; providing care for residents during COVID-19 pandemic; measures to protect residents in the shielding category; measures for residents exposed to a case of COVID-19; admission of individuals to the care home; testing in the care home; care home placement for symptomatic residents; Personal Protective Equipment (PPE); care equipment; staffing, including staff cohorting and staff testing; visiting care homes; and caring for a resident who has died. Last updated: Version 2.1 Publication date: 31 December 2020

Last updated on hub: 20 October 2020