COVID-19 resources on Home care

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Survey of NCF membership: impact of the Omicron variant

National Care Forum

Findings from a survey of NCF Membership on the impact of the Omicron variant, suggesting an increase in the pressures facing the social care sector as a result of the new variant compounded by the limitations of government support on the frontline. 66% of the homecare providers responding are now having to refuse new requests for home care and 43% of providers of care homes are closing to new admissions, while 21% of providers of home care are handing back existing care packages. Overall, the providers responding reported 18% vacancy rate and 14% absence as a result of the Omicron variant. While the absence rate may be temporary, the vacancy rate has been well documented as growing at an alarming rate over the last six months and has been compounded by other policy decisions such as mandating vaccines as a condition of deployment.

Last updated on hub: 25 January 2022

Coronavirus (COVID-19) vaccination as a condition of deployment for the delivery of CQC-regulated activities in wider adult social care settings

Department of Health and Social Care

This guidance supports the implementation of the Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2022, in wider social care settings, including home care, extra care housing and supported living. From 1 April 2022, social care providers registered with the Care Quality Commission (CQC) must ensure that anyone they employ or engage to carry out direct and face-to-face CQC-regulated social care activities meets the vaccination requirements as set out in this guidance. The person must be able to prove that they meet one of the following: satisfy the vaccination requirements; are exempt from vaccination; are covered by other exceptions. There is separate guidance on implementing these regulations in care homes. [First published: 20 January 2022. Last updated: 1 March 2022]

Last updated on hub: 24 January 2022

The COVID-19 pandemic as experienced by the spouses of home-dwelling people with dementia – a qualitative study

BMC Geriatrics

Background: Worldwide, restrictive measures have been taken to manage the spread of the COVID-19 pandemic. Social distancing and self-isolation have considerably affected the lives of people with dementia and their informal caregivers. The purpose of the study was to explore the consequences of the COVID-19 pandemic as experienced by the spouses of home-dwelling people with dementia in Norway. Methods: The study had a qualitative descriptive design using individual telephone interviews for data collection. A total sample of 17 spouses of people with dementia were included, 14 women and three men ages 52 to 82 years. A qualitative content analysis following six steps inspired by Graneheim and Lundman was used to identify the categories presented. Results: The participants emphasized four main perspectives: 1) Radical changes in available services, 2) Restrictions changed everyday life, 3) Impacts on health and well-being, and 4) Actions that made life easier. The participants also described how positive activities and easily accessible services helped them in this situation. Conclusions: The governmental restrictions of the COVID-19 pandemic resulted in radical changes in available services with severe consequences for the lives and well-being of home-dwelling people with dementia and their spouses. Examples of coping strategies and possible psychosocial interventions compatible with virus precautions were identified. The potential of such interventions should be further explored to meet the needs of vulnerable groups in situations like a pandemic.

Last updated on hub: 19 November 2021

Making vaccination a condition of deployment in health and wider social care sector: government response to public consultation

Department of Health and Social Care

Government’s response to a consultation on whether or not the government should extend the existing statutory requirement, for those responsible for care homes to ensure that they have evidence that those working or volunteering in a care home have been vaccinated against COVID-19, to other health and care settings, as a condition of deployment. DHSC undertook thorough analysis of the more than 34,900 consultation responses and considered the feedback received. Overall, the consultation showed that, while a majority of respondents (65%) did not support the proposal, the responses from the health and social care sector were mixed, with some groups (for example managers of healthcare or social care services) mostly supporting the proposed legislative change while others (for example service users and relatives of service users) were mostly opposed. However, in order to help protect people receiving health and social care, who may be more clinically vulnerable to COVID-19, the government will be introducing regulations to only allow providers of CQC-regulated activities, including hospitals, GP practices, and where care is delivered in a person’s home, to deploy individuals who have been vaccinated against COVID-19 to roles where they interact with patients and service users. These regulations will require workers who have direct, face to face contact with service users to provide evidence that they have been vaccinated, subject to limited exceptions.

Last updated on hub: 10 November 2021

Adult social care: COVID-19 winter plan 2021 to 2022

Department of Health and Social Care

Building on last year’s adult social care coronavirus (COVID-19) winter plan 2020 to 2021, this plan sets out the: key elements of national support available for the social care sector during winter 2021 to 2022; and principal actions that local authorities, NHS organisations and social care providers across all settings (including those in the voluntary and community sector) in England should take this winter. Its aims are to ensure that high-quality, safe and timely care is provided to everyone who needs it, while we continue to protect people who need care, their carers and the social care workforce from COVID-19 and other respiratory viruses. Each section of the plan – Preventing and controlling the spread of infection in care settings, Collaboration across health and care services, Supporting the people who provide care, Supporting the system – sets out the government’s offer of national support and our expectations for adult social care providers alongside published guidance. The plan applies to all settings and contexts in which people receive adult social care. This includes people’s own homes, residential care homes and nursing homes, and other community settings. Alongside this plan, the Social Care Sector COVID-19 Support Taskforce’s independent review of the government’s adult social care: winter plan 2020 to 2021 has been published.

Last updated on hub: 08 November 2021

Personal Assistants’ role in infection prevention and control: their experiences during the Covid-19 pandemic

Health and Social Care in the Community

Personal Assistants (PA) or client-hired workers are directly employed by people needing care and support, often making use of government funding. In the context of Covid-19, questions emerged about how this workforce is supported to practice safely. This paper reports PAs’ understanding and views of infection control during the early months of the Covid-19 pandemic in England. Telephone interviews were undertaken with 41 PAs between 16th April and 21st May 2020. PAs were recruited from a sample that had participated in a previous study in 2014–16. Interview questions focused on changes arising from the pandemic. Data were transcribed and analysed using Framework analysis. This paper focuses on PAs’ perceptions of their role and responsibilities in preventing and managing infection. Arising themes were identified about barriers and facilitators affecting infection control in five areas: accessing information, social isolation, handwashing, hygiene, personal protective equipment and potential attitude to vaccines. Infection prevention and control are under-researched in the home care sector generally and efforts are needed to develop knowledge of how to manage infection risks in home settings by non-clinically trained staff such as PAs and how to engage home care users with these efforts, especially when they are the direct employers.

Last updated on hub: 03 November 2021

Brexit and the migrant care workforce: future policy directions

Centre for International Research on Care, Labour and Equalities (CIRCLE)

Migrant workers have been vital in helping to fill labour gaps locally and regionally and across different types of social care services in the UK over the last few decades. Brexit and the UK’s decision to end free movement for EEA workers was expected to bring significant new challenges to the sector as a whole, and homecare in particular. In 2019, we launched a two-wave expert (Delphi) survey to explore what the future role and composition of this workforce could look like after Brexit within the context of broader sectoral challenges. In March 2020, the first wave of the Covid-19 pandemic hit the UK and created unprecedented challenges for social care. The second (final) round of the survey was conducted in the summer of 2020. It set out to identify points of consensus about major considerations associated with recruitment and retention in homecare in the context of the ongoing Covid-19 pandemic and Brexit. This short report summarises the second-round results of the expert survey and sets out some primary considerations and policy directions for the homecare sector at a time of uncertainty. The findings of this Delphi Survey confirm that a range of experts perceives Brexit as likely to impact homecare by reducing labour supply significantly – an impact perceived to vary by geographical area and type of care provision. There is substantial uncertainty, with many unknown factors, regarding the future of migrant labour in UK homecare and in social care in general. At this stage, it is impossible to fully disentangle the impacts on the workforce of the new immigration system, Brexit and the COVID-19 pandemic. The key message of the expert survey is that the priority should be to improve the homecare sector as part of broader social care reform. This reform needs to acknowledge the significant contribution of migrants who work in homecare. Measures are needed to promote their retention and to ensure that their involvement in the sector is regulated in a way that safeguards their rights and the quality of care provided.

Last updated on hub: 02 November 2021

Crystallising the case for deinstitutionalisation: COVID-19 and the experiences of persons with disabilities

This report summarises the evidence and experiences of persons living in congregate settings in general, and in terms of the impact of COVID-19, to understand the barriers to deinstitutionalisation, and to highlight the approaches that have sought to overcome those barriers. It considers all disabilities and long-term conditions that might lead to institutionalisation, for all age groups across the world. Congregate care remains a main form of provision for adults with disabilities in many countries, and the number of persons placed in congregate settings is rising in some regions of the world. Yet, overall, the majority of older persons experience better health, rights, and quality of life when support is provided in the community. Comparisons of community-based services with congregate living for persons with psychosocial or intellectual disabilities have consistently shown better outcomes, for example, in terms of health, quality of life, vocational rehabilitation, self-management and autonomy. A majority of persons strongly prefer living in community rather than institutional or hospital settings. A key barrier to deinstitutionalisation is prejudice against persons with disabilities and ageism, and therefore a lack of societal commitment to change the status quo. While with suitable community-based services, families can ensure better quality of life than is experienced in institutional settings, there may be no family members or friends available to be carers. There is also the challenge of shifting resources tied up in institutions and making them available for community support. Alternatives to congregate care settings may be seen as ‘too expensive’ by decisionmakers. Furthermore, the lack of legal and policy frameworks encompassing new community-based services in many countries creates a ‘perverse incentive’ in favour of placing persons with disabilities in institutions. The report argues that successful deinstitutionalisation requires long-term service planning, financial commitment and policy that looks beyond the electoral cycle.

Last updated on hub: 22 October 2021

ADASS home care and workforce snap survey: September 2021

Association of Directors of Adult Social Services

The ADASS survey was carried out in August 2021 and was completed by 69 Director of Adult Social Services (45% of councils in England). They were asked how waiting lists, homecare hours delivered and people not getting the kind of care they would choose. The report suggests that nearly 300,000 people (294,353) are waiting for social care assessments, care and support or reviews. This figure has increased by just over a quarter (26%) over the last three months. Drilling down into the headline figure - 70,000 people are waiting for care assessments (up from 55,000 at the time of the ADASS Spring Survey 2021). 11,000 people have been waiting for more than six months (compared to 7,000 at the time of the ADASS Spring Survey). The number of hours of care that are needed locally but that there is not the capacity to deliver has doubled over the last six-month period. 13% of people are being offered care and support such as residential care that they would not have chosen, due to recruitment and retention issues. The findings point to funding pressures and delays in assessments from social workers and shows that whilst councils are delivering more care and support in people’s homes, people are waiting longer for vital care assessments and reviews. The findings also suggest that there are fundamental issues relating to hospital discharges, increasing requests for care and support, and the detrimental impact of decision-making on the lives of so many older and disabled people. The findings reaffirm and compound what was found in the earlier ADASS Activity Survey (June 2021) and Spring Survey (July 2021), which showed increasing requests to local authorities for care and support in their own homes, growing levels of unmet need, people waiting longer, and more people missing out on vital care and support.

Last updated on hub: 08 September 2021

Healthcare leaders’ use of innovative solutions to ensure resilience in healthcare during the Covid-19 pandemic: a qualitative study in Norwegian nursing homes and home care services

BMC Health Services Research

Background: The Covid-19 pandemic introduced a global crisis for the healthcare systems. Research has paid particular attention to hospitals and intensive care units. However, nursing homes and home care services in charge of a highly vulnerable group of patients have also been forced to adapt and transform to ensure the safety of patients and staff; yet they have not received enough research attention. This paper aims to explore how leaders in nursing homes and home care services used innovative solutions to handle the Covid-19 pandemic to ensure resilient performance during times of disruption and major challenges. Methods: A qualitative exploratory case study was used to understand the research question. The selected case was a large city municipality in Norway. This specific municipality was heavily affected by the Covid-19 pandemic; therefore, information from this municipality allowed us to gather rich information. Data were collected from documents, semi-structured interviews, and a survey. At the first interview phase, informants included 13 leaders, Head of nursing home (1 participant), Head of Sec. (4 participants), Quality manager (4 participants), Head of nursing home ward (3 participants), and a Professional development nurse (1 participant), at 13 different nursing homes and home care services. At the second phase, an online survey was distributed at 16 different nursing homes and home care services to expand our understanding of the phenomenon from other leaders within the case municipality. Twenty-two leaders responded to the survey. The full dataset was analysed in accordance with inductive thematic analysis methodology. Results: The empirical results from the analysis provide a new understanding of how nursing homes and home care leaders used innovative solutions to maintain appropriate care for infected and non-infected patients at their sites. The results showed that innovative solutions could be separated into technology for communication and remote care, practice innovations, service innovations, and physical innovations. Conclusion: This study offers a new understanding of the influence of crisis-driven innovation for resilience in healthcare during the Covid-19 pandemic. Nursing home and home care leaders implemented several innovative solutions to ensure resilient performance during the first 6–9 months of the pandemic. In terms of resilience, different innovative solutions can be divided based on their influence into situational, structural, and systemic resilience. A framework for bridging innovative solutions and their influence on resilience in healthcare is outlined in the paper.

Last updated on hub: 01 September 2021

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