COVID-19 resources on infection control

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Dementia and COVID-19: social contact

Alzheimer's Society

This briefing sets out the evidence for action to support social contact for people living with dementia and what the Government need to do next. It covers: the impact of COVID-19 on people with dementia in the UK; the importance of social contact for people living with dementia; maintaining social contact in care homes; supporting the delivery of home care services. The briefing observes that as well as the severe impact of COVID-19 itself, restrictions under lockdown have imposed a lack of social contact and interaction which are known to be contributing factor in the decline of people with dementia. The paper calls on the Government to lead a task force with Local Authorities and expert groups to address how they will support people with dementia as the country emerges from the lockdown over the next 6-12 months, with social contact at the heart of the solution. Specific recommendations for both care homes and home care are included.

Last updated on hub: 10 August 2020

Dementia and social contact

Alzheimer's Society

This briefing outlines the importance of social contact for people living with dementia during the COVID-19 pandemic. It sets out what actions local government can take to ensure that people living with dementia do not see their symptoms deteriorate as a result of limited social contact.

Last updated on hub: 10 August 2020

Detrimental effects of confinement and isolation on the cognitive and psychological health of people living with dementia during COVID-19: emerging evidence

International Long-term Care Policy Network

This report contains a short review of the emerging evidence on the impact of COVID-19 on the cognitive and psychological health of people living with dementia and the reported mitigating measures. Three papers describing the effects of lockdown on people with dementia living in the community show a worsening of functional independence and cognitive symptoms during the first month of lockdown (31% of people surveyed) and also exacerbated agitation, apathy and depression (54%), along with the deterioration of health status (40%) and increased used of antipsychotics or related drugs (7%). People with frontotemporal dementia (FTD) and their family caregivers seem to be particularly struggling to comply with protective measures. Only 2 case studies reporting strategies to support people with dementia in care homes have been produced so far. One describes a quarantine care plan for a person with FTD and the other, a mitigating strategy to ease the distress experienced by a man when his family stopped visiting during the pandemic. People living with dementia in care homes have experienced a particularly harsh version of lockdown – the ban on visits from spouses and partners in care is believed to be causing a significant deterioration in the health and wellbeing of residents with dementia. It is worth noting that a study involving 26 care homes proved that it is possible to implement successful infection control measures at the same time that visits are permitted. Learnings from this first COVID-19 wave can help the home care and day care sector prepare to minimise the disruption of their services in future waves so support can continue for people with dementia in the community. In care homes, evidence-based compassionate protocols should contribute to mitigating the detrimental effects of isolation and quarantine in residents with dementia (and their families).

Last updated on hub: 04 November 2020

Did the UK government really throw a protective ring around care homes in the COVID-19 pandemic?

Journal of Long-Term Care

Context: COVID-19 has disproportionately impacted mortality in English care homes. Objectives: To examine COVID-19 policies for care homes in England and to describe providers’ experiences of those policies in May and June 2020. Methods: Mixed methods including policy analysis and an anonymous online survey of English care home providers, recruited using webinars and WhatsApp groups about their experiences of funding, testing, PPE, isolation and staffing until the end of May and early June 2020. Findings: Although social care policies in England have aligned with those advised by the World Health Organization, they were arguably delayed and were not implemented effectively. Testing had taken place in 70% of care homes surveyed but only 36% of residents had been tested, of whom 16% were positive. Managers were unable to effectively implement isolation policies and reported that workforce and funding support did not always reach them. Guidance changed frequently and was conflicting and could not always be implemented, for example when personal protection equipment was extremely expensive and difficult to source. Limitations: Although this was not a representative sample, care homes responded from across the country and this study reports the most consistent themes. Potentially, care homes that found it harder to implement national guidance may have been more inclined to respond to the survey than those who more easily changed practice, although those with outbreaks may also have had less capacity to respond. Some aspects of policy will have also changed since early June. Implications: Despite policies that were put in place, care homes amongst the survey respondents were still unable to access sufficient funding, testing, PPE, workforce support and practical support to isolate residents by the end of May and early June. Future cross-country policy analyses must examine policy implementation as well as content.

Last updated on hub: 11 November 2020

Digital health and Covid-19: a PRSB consultation

Professional Record Standards Body

Findings of a consultation exploring the role of digital in responding to the pandemic; the opportunities and challenges encountered and the lessons for the future; and views on ways in which PRSB and its members can influence this agenda. The report reveals that the experience of a shift to digitally enabled working was, on balance, seen as positive by both professionals and people using services; the benefits from remote consultation went beyond convenience and a reduced risk of infection, particularly for people who have found traditional consultations a challenge; almost universally, there was a sense that many of the changed ways of working, with adjustment where necessary, should be retained; however, poor infrastructure, multiple platforms, and lack of interoperability across many health and social care settings prevented optimal service delivery; remote and self-monitoring tools have great potential, but they need standardising, integration, quality control and risk management; data requirements, for practice, governance and for research, need much better planning and coordination and reducing burden is essential; the pace of change in practice has not been matched by updated and responsive protocols for information sharing, leading to suboptimal care and frustration; the care sector, and social care, despite welcome developments such as access to NHSMail during the crisis, experience challenges in the timely access to information that could improve outcomes and experience for people. The report sets out a comprehensive set of recommendations addressing each of the priorities for action identified in the consultation.

Last updated on hub: 24 November 2020

Direct and indirect impacts of COVID-19 on health and wellbeing: rapid evidence review

Liverpool John Moores University

This rapid review identifies the current evidence on the direct and indirect impacts of COVID-19 on health and wellbeing. Rapid searches were carried out of the academic and grey literature between 18 May and 8 June 2020 to scope and collate evidence. These sources were analysed and used to prepare this rapid evidence review. The findings show that the impacts of COVID-19 have not been felt equally – the pandemic has both exposed and exacerbated longstanding inequalities in society. Conversely, there is also evidence of increased civic participation in response to the pandemic and a positive impact on social cohesion. However, social isolation and loneliness have impacted on wellbeing for many. There are serious concerns about how the combination of greater stress and reduced access to services for vulnerable children and their families may increase the risk of family violence and abuse. Compounding this, safeguarding issues have been largely hidden from view during lockdown. In addition, the review finds that the pandemic has both disrupted and changed the delivery of NHS and social care services. Concerns have been raised about significant drops in A&E use and the health care needs of people with long-term conditions have been significantly impacted. The report concludes by arguing that as we move from the response phase into recovery, the direct and wider impacts of the pandemic on individuals, households and communities will influence their capacity to recover.

Last updated on hub: 28 July 2020

Disability inclusive Covid-19 response

House of Commons Library

This briefing offers an overview of key aspects relating to efforts to include people with disabilities in the Government’s response to the Covid-19 pandemic. Focusing on England, it provides information on the Equality Act 2010, the wearing of face coverings, access to education and health services, employment support and social care during the coronavirus outbreak.

Last updated on hub: 15 October 2020

Discharge into care homes for people who have tested positive for COVID-19

Department of Health and Social Care

This note has been created for care homes to simplify and clarify existing national guidance on discharge into care homes, particularly in relation to people who have tested positive for COVID-19. The current requirement is for hospitals to undertake a COVID-19 PCR test on all people discharged into a care home in the 48 hours prior to discharge. All individuals who test positive within this timeframe should be discharged into designated settings in the first instance. An exception to this process is for individuals who have tested positive for COVID-19 and are within 90 days of their initial illness onset or positive test date. If these individuals have already completed their 14-day isolation period from onset of symptoms or positive test result (if asymptomatic) and have no new COVID-19 symptoms or exposure, they are not considered to pose an infection risk. They therefore do not have to be re-tested and can move directly to a care home from hospital. The document sets out the key roles of care homes and hospitals and the steps for discharge into care homes for people who have tested positive for COVID-19.

Last updated on hub: 27 January 2021

Discharge into care homes: designated settings

Department of Health and Social Care

This guidance is for local authorities, clinical commissioning groups, care providers and people who use these services. It sets out: advice on setting up designated settings, and information for local authorities and providers; information on discharge arrangements, and supporting individuals to ensure that their care needs and preferences are accounted for; additional advice on data collection, funding, visiting, and infection prevention and control (IPC) requirements. A designation scheme has been introduced to ensure that everyone being discharged from hospitals to care homes who is COVID-19 positive, is discharged to premises that meet a set of agreed control standards to complete the recommended 14-day isolation period. Local authorities must have access to at least one designated setting or suitable alternative premises (for example, NHS community hospital beds). [First published 16 December 2020. Last updated 25 January 2021]

Last updated on hub: 22 December 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

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