COVID-19 resources on Care homes

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Technical report on the COVID-19 pandemic in the UK

Department of Health and Social Care

This report on COVID-19 has a specific and narrow audience: future UK Chief Medical Officers (CMOs), Government Chief Scientific Advisers (GCSAs), National Medical Directors and UK public health leaders facing a new pandemic or major epidemic. Several questions are central to developing the most efficient and effective countermeasures to any novel pathogen. A lot of this report is about how in this pandemic, at this point in science, the UK built up a picture of the key information needed for pharmaceutical and non-pharmaceutical public health interventions. This key information includes modes of transmission for SARS-CoV-2, common transmission settings, mortality rate in different ages and risk-groups of society, the relative importance of asymptomatic infection, the nature of immunity and reinfection. We then look at technical aspects of several of the interventions. In each section it will be obvious that the picture emerged gradually and from multiple lines of evidence from different disciplines, and the path to creating the picture was neither linear nor straightforward. Many of the important initial decisions by policymakers in a pandemic have to be taken when many key facts are unknown, or at least uncertain. In each chapter we draw out points we think may be helpful in the future as we go along, and in several we add some additional reflections for our successors to consider. Chapters cover: understanding the pathogen; disparities; research; situational awareness, analysis and assessment; modelling; testing; contact tracing and isolation; non-pharmaceutical interventions; NPIs in education settings; care homes; pharmaceutical interventions - therapeutics and vaccines; improvements in care of COVID-19; communications.

Last updated on hub: 05 December 2022

Lessons from the COVID-19 pandemic

British Geriatrics Society

This report aims to reflect on the experiences of the pandemic from the specific perspective of older people's healthcare. The COVID-19 pandemic will not be the last pandemic and, given our ageing society, it is unlikely to be the last pandemic that affects older people more than any other population group. We have aimed to highlight both the positive and negative aspects of the handling of the pandemic and have drawn out ten lessons that must be learnt by governments and healthcare organisations before the next pandemic. The report sets out ten lessons from the pandemic: 1. Treatment decisions should always be tailored to the individual patient and blanket decisions should never be applied to an entire patient group; 2. There is a need to ensure that a balance is achieved between protecting care home residents from a virus that could be fatal for them and also protecting the human rights of individuals to see their families and loved ones; 3. Services should be available and adequately funded to provide patients with the most appropriate care in the best place for them - for some patients, this will be hospital but for others, it will not; 4. During a pandemic, particular attention should be paid to the risk of contracting the illness in patients admitted to hospital for unrelated illnesses and measures must be taken to prevent this happening; 5. Planning for the response to a pandemic should involve experts on the population most affected by the illness in question - these experts should be involved at the earliest possible stage; 6. Clinical trials must include the populations most at risk and most likely to benefit from the treatments being tested - in the majority of cases, this will include older people; 7. Quick development and rollout of the vaccine was essential - during a pandemic, sufficient funding should always be made available to ensure that scientists are able to collaborate and develop vaccines quickly; 8. A time of great crisis can also bring great innovation - changes made during a crisis that are beneficial to patients should be retained; 9. Measures taken to curb the impact of a pandemic may have unintended but serious consequences on the health of many older people - these consequences must be identified as quickly as possible and mitigating action taken; 10. NHS workforce planning must cover three crucial elements - ensuring there are enough staff, ensuring all NHS staff have the skills they need to care for the ageing population and ensuring that staff are cared for mentally and emotionally and are supported to remain working in the NHS. The impact of not doing so may be catastrophic for individuals and society.

Last updated on hub: 18 November 2022

COVID-19 PPE guide for adult social care services and settings: what PPE to wear and when: an illustrative guide

Department of Health and Social Care

This resource outlines personal protective equipment (PPE) advice for health and social care workers working in the community. The guide shows which PPE to wear depending on where and how you are working; and how to use PPE safely to help protect staff and residents. This guidance is of a general nature and an employer should consider the specific conditions of each individual place of work and comply with all applicable legislation, including the Health and Safety at Work etc. Act 1974.

Last updated on hub: 13 October 2022

Care home quality assurance in COVID-19

The Institute for Research and Innovation in Social Services

A review of care home quality assurance materials from 17 local authority areas in Scotland to understand how improvement is best supported during periods of acute crisis. It draws out: what was learned about how care homes were managing during the COVID-19 crisis; the local authority approaches to assurance and improvement; examples of creative practice and areas for development. The findings from the assurance visits reflect how the COVID-19 crisis highlighted existing tensions, challenges, and structural issues within care homes and their relationship with the wider health and social care support sectors. The findings highlight the significant tensions between social work/social care support and clinical perspectives on wellbeing, risk, and safety. This tension recurred across almost all identified themes from the care home environment, accommodating people who walk with purpose, maintaining social connections and being, through to seemingly minor decisions such as the reintroduction of uniforms in otherwise homely settings. Working effectively with this tension will be key to recovery from COVID-19; with the recognition that the balance between social and clinical 'safety' may need to be reset, most urgently where human rights concerns come into play.

Last updated on hub: 29 September 2022

Understanding the distinct challenges for nurses in care homes: learning from Covid-19 to support resilience and mental wellbeing

University of East Anglia

This study aimed to understand the distinct challenges faced by registered nurses (RNs) working in the care home sector during the COVID-19 pandemic, how RNs managed these stresses and challenges and to co-produce recommended strategies which would be feasible and acceptable to supporting the future wellbeing of care-home RNs. The study was conducted in two phases and for both phases we recruited NMC-registered nurses - the eighteen interview participants and twelve workshop attendees came mainly from England and Scotland, and most were female with an Adult Nurse registration (three reported a Mental Health Nurse registration). The study identified six activities or practices which can support the wellbeing of RNs working in care homes during the COVID-19 pandemic. These are: a formal, bespoke mental health and wellbeing strategy for nurses and staff working in care homes; debriefing sessions; emotional support networks; improving communication from external agencies to care homes as well as within care homes; providing training and career development opportunities for the whole care-home workforce; improved planning for future pandemics and major unplanned events.

Last updated on hub: 19 July 2022

The Italian experience in protecting older people during COVID-19: lessons learned for long-term care facilities (LTCF)

Journal of Long-Term Care

Context: Older people living in LTCF were particularly affected by COVID-19. Italy was the first country in Europe to experience high death rates among older people. Analysing the factors which may have determined high mortality rates in LTCF and identifying actions to safeguard older people's health in long-term care settings may be critical for future public health emergencies. Objectives: Identify the main challenges and failures faced by a small number of Italian professionals working in LTCF and suggest key actions to better protect older people's health in future emergencies. Methods: Rapid survey conducted among Italian professionals working in the LTC sector in Italy during the pandemic. Findings: Several factors contributed to higher death rates in LTCF for older people in Italy. To better protect LTCF residents in case of future health emergencies, actions need to be implemented in relation to LTCF’s management, governance and capacity building. Furthermore, safety plans and strategies need to be put in place to ensure older residents' protection and maintain high level of care in LTCF during public health emergencies, such as COVID-19. Limitations: The article reflects the opinions of a limited number of professionals working in the long-term care sector, which may not be representative of all workers operating in the sector. Implications: Policy and system changes are needed to strengthen the capacity of the Italian long- term care sector to respond to the needs of a growing older population in the context of COVID-19 and beyond.

Last updated on hub: 13 June 2022

Exploring vaccine hesitancy in care home employees in North West England: a qualitative study

BMJ Open

Objectives: Care homes have experienced a high number of COVID-19 outbreaks, and it is therefore important for care home employees to receive the COVID-19 vaccine. However, there is high vaccine hesitancy among this group. We aimed to understand barriers and facilitators to getting the COVID-19 vaccine, as well as views on potential mandatory vaccination policies. Design: Semi-structured interviews. Setting: Care home employees in North West England. Interviews conducted in April 2021. Participants:10 care home employees (aged 25-61 years) in the North West, who had been invited to have, but not received the COVID-19 vaccine. Results: We analysed the interviews using a framework analysis. Our analysis identified eight themes: perceived risk of COVID-19, effectiveness of the vaccine, concerns about the vaccine, mistrust in authorities, facilitators to getting the vaccine, views on mandatory vaccinations, negative experiences of care work during the COVID-19 pandemic, and communication challenges. Conclusions: Making COVID-19 vaccination a condition of deployment may not result in increased willingness to get the COVID-19 vaccination, with most care home employees in this study favouring leaving their job rather than getting vaccinated. At a time when many care workers already had negative experiences during the pandemic due to perceived negative judgement from others and a perceived lack of support facing care home employees, policies that require vaccination as a condition of deployment were not positively received.

Last updated on hub: 03 May 2022

Working in a care home during the COVID-19 pandemic: How has the pandemic changed working practices? A qualitative study

BMC Geriatrics

Background: The pandemic has significantly affected care homes' residents and families through the national visiting restrictions. However, less is known on the impact these changes have had on the care home workforce. The aim of this research was to explore the impact of COVID-19 on the working practices of care home staff, caring for people living with dementia. Methods: Remote qualitative, semi-structured interviews were conducted with care home staff caring for people living with dementia (PLWD) in the UK. Results: Participants were recruited to the larger programme of research via convenience sampling. Interviews were conducted via telephone or online platforms. This research employed inductive thematic analysis. Sixteen care home staff were included in this study. Three overarching themes were developed from the analysis that conveyed changes to the everyday working practices of the care home workforce and the impact such changes posed to staff wellbeing: (1) Practical implications of working in a care home during the COVID-19 pandemic; (2); Staff values and changes to the staff roles (3): Impact to the care home staff and concerns for the care sector. Conclusions: The COVID-19 pandemic has significantly disrupted the daily working practices of care home staff, with staff forced to adopt additional roles on top of increased workloads to compensate for the loss of external agencies and support. Support and guidance must be offered urgently to inform care home staff on how to best adapt to their new working practices, ensuring that they are adequately trained.

Last updated on hub: 21 April 2022

Infection prevention and control in social care (Social care transition plan)

Welsh Government

Guidance on infection prevention and control measures for social care in Wales. This document is intended to provide the social care sector with an outline summary of changes to the Test, Trace, Protect (TTP) arrangements and infection prevention control (IPC) guidance as the Covid-19 alert level is eased. It incorporates advice on care homes, visiting care homes, care home residents, declaring and outbreak and outbreak management in care homes. This document signposts to more detailed Welsh Government and Public Health Wales guidance. A quick reference guide to the key messages can be found at Annex 1.

Last updated on hub: 13 April 2022

COVID-19 testing in adult social care

UK Health Security Agency

This guidance outlines the COVID-19 testing available for testing staff, residents and visitors for all adult social care settings. The guidance covers: eligibility for free testing in adult social care; symptomatic testing for staff and residents; asymptomatic staff testing; rapid response testing in care homes and high-risk extra care and supported living; outbreak testing in care homes; and step by step testing process for all adult social care. This page also brings together guidance documents on specific aspects of testing, including: how to use your rapid lateral flow test; testing terms and conditions; and self-test for staff, service users and visitors in adult social care settings: privacy notice. [First published 24 March 2021. Last updated 31 March 2022]

Last updated on hub: 07 April 2022

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