COVID-19 resources on infection control

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Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care Homes

Journal of Infection

Background: Care homes have been disproportionately affected by the COVID-19 pandemic and continue to suffer large outbreaks even when community infection rates are declining, thus representing important pockets of transmission. We assessed occupational risk factors for SARS-CoV-2 infection among staff in six care homes experiencing a COVID-19 outbreak during the peak of the pandemic in London, England. Methods: Care home staff were tested for SARS-COV-2 infection by RT-PCR and asked to report any symptoms, their contact with residents and if they worked in different care homes. Whole genome sequencing (WGS) was performed on RT-PCR positive samples. Results: In total, 53 (21%) of 254 staff were SARS-CoV-2 positive but only 12/53 (23%) were symptomatic. Among staff working in a single care home, SARS-CoV-2 positivity was 15% (2/13), 16% (7/45) and 18% (30/169) in those reporting no, occasional and regular contact with residents. In contrast, staff working across different care homes (14/27, 52%) had a 3.0-fold (95% CI, 1.9–4.8; P<0.001) higher risk of SARS-CoV-2 positivity than staff working in single care homes (39/227, 17%). WGS identified SARS-CoV-2 clusters involving staff only, including some that included staff working across different care homes. Conclusions: SARS-CoV-2 positivity was significantly higher among staff working across different care homes than those who were working in the same care home. We found local clusters of SARS-CoV-2 infection between staff only, including those with minimal resident contact. Infection control should be extended for all contact, including those between staff, whilst on care home premises.

Last updated on hub: 19 October 2020

Infection control during COVID-19: advice for social care

Social Care Institute for Excellence

Advice and training for the social care sector about infection control during the coronavirus (COVID-19).

Last updated on hub: 22 July 2020

Infection control e-learning course

Social Care Institute for Excellence

Video-based, easy-to-navigate, essential e-learning to help organisations prevent the spread of infection.

Last updated on hub: 07 May 2020

Infection prevention and control

Skills for Care

Learning resources for ongoing learning and development in relation to safe and effective care, infection prevention and control. Includes webinar recordings about Coronavirus infection prevention and control in nursing homes (3 April 2020); infection prevention and control Q&A session (14 April 2020) and links to other relevant resources for induction and learning and development.

Last updated on hub: 22 July 2020

Infection prevention and control in care homes

Care Quality Commission

A set of questions and prompts used by CQC inspectors to assess how well staff and residents of care homes are protected by infection prevention and control, including checks for COVID-19 mitigation. Last updated:19 January 2021.

Last updated on hub: 20 October 2020

Infection prevention and control information

Harrogate and District NHS Foundation Trust

Produced by the team employed by Harrogate and District NHS Foundation Trust and commissioned to provide infection prevention and control (IPC)services in North Yorkshire covering Health and Social Care settings. Offers bespoke training and consultancy services, as well as an variety of downloadable resources for care homes and home care.

Last updated on hub: 22 July 2020

Informal dementia carers had to make difficult decisions about paid care during COVID-19

National Institute for Health Research

Explores how the first nationwide COVID-19 lockdown affected unpaid carers, and how they made decisions about accessing paid care. This research brings to the fore longstanding problems with care for people living with dementia. These issues include a lack of continuity of paid care, poor monitoring of care staff entering homes, and minimal support for unpaid carers. The research team interviewed 15 unpaid carers by telephone between April and May 2020. All carers had been accessing or trying to access paid home care before the pandemic. All were adult family or friends of someone with dementia. The researchers drew three themes from the interviews: carers felt concerned by the risk of paid carers bringing coronavirus into the home – lack of personal protective equipment (PPE) and feeling unprepared to provide additional care heightened these fears; carers had difficult choices to make – many avoided hospitals and other health providers and struggled to weigh up the options of cancelling or continuing paid care and some described real fears of re-obtaining paid care post-COVID if they cancelled during lockdown; and implications for unpaid carers included increased workload and difficulty in accessing food deliveries.

Last updated on hub: 11 January 2021

Informal home care providers: the forgotten health-care workers during the COVID-19 pandemic

Lancet

Editorial states that during the current coronavirus (COVID-19) pandemic, informal home care provision and challenges faced by care providers, excluding those who are formal and paid, in the home context have largely been overlooked. Also makes the point that in public health emergencies, informal home care providers are a crucial human resource that improves the community’s health-care capacity, especially in regions with an ageing population and areas with suboptimal health-care systems. The comment piece suggests that for home care to better support health needs during extreme events, urgent research related to social and economic impacts of home care is needed to update policies and improve health support programmes. The piece also provides a list of research priorities relevant to informal home care providers.

Last updated on hub: 20 June 2020

International “living” report: long-term care and COVID-19 vaccination, prioritization and data

International Long-term Care Policy Network

This report aims to provide an overview of progress in the delivery of COVID-19 vaccinations to people who use and provide long-term care. It is a “living report” that will be updated regularly. The report shows data for populations that either use and provide long-term care or are likely to do so. Initial review of prioritization documents shows that care home residents and personnel are consistently listed among the group with the highest priority. Care partners and family members of residents and unpaid carers of people living in the community are not explicitly mentioned. There are few mentions of people living with dementia or people with learning disabilities.

Last updated on hub: 11 January 2021

International evidence on care home COVID-19 outbreak responses: summary of key findings

International Long-term Care Policy Network

This note summarises emerging evidence on COVID-19 outbreak responses in care homes, obtained from a “living” systematic review that focused on COVID-19 mortality and spread of disease in long-term care more broadly (Salcher-Konrad & al. (2020). COVID-19 related mortality and spread of disease in long-term care: a living systematic review of emerging evidence). The review found that outbreaks in long-term care settings varied widely in terms of the number of people affected, and that evidence on the reasons behind this variation is still emerging. It identifies four measures that may have worked in containing COVID-19 outbreaks in care homes: early detection and rapid response after detection of index case; systematic testing of all residents and staff – high prevalence of asymptomatic and presymptomatic cases that would not be detected by a) symptoms screening, and b) one-off testing (if infection has already spread beyond index case); moving high-risk contacts of cases out of the facility; and isolating cases by removing them from the facility or creating separate wards within the facility.

Last updated on hub: 04 November 2020

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