COVID-19 resources on Home care

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Mitigating the impact of the COVID-19 outbreak: a review of international measures to support community-based care

International Long-term Care Policy Network

This report provides a brief overview of the policy responses and practice measures used internationally to respond to the impact of COVID-19 on the provision of community-based care. The data provided is largely collected from the country reports on the COVID-19 long-term care situation, including Australia, Austria, Brazil, China, England, Germany, Hong Kong, Ireland, Israel, Italy, Netherlands, Slovenia, South Korea, and the United States. Key findings include: community-based care faces unique challenges during the COVID-19 pandemic compared to other parts of the long-term care continuum; several countries have taken steps to prevent the spread of COVID-19 infections in community-based care including the closure of adult day centres and other service providers; continuity of care is of upmost importance – a disruption of care and support could have serious negative impacts on individual health and well-being due to increased risk of loneliness and social isolation; the dispersed nature of community based care suggests that direct governmental action and oversight may be more difficult to provide than for residential care settings such as care homes or nursing facilities; efforts to maintain continuity of care in community-based care include government financial support to home care workers; recruitment of volunteers and family members to act as paid carers; and the provision of remote psychological supports to home care workers; some countries have taken steps to move patients and home care workers to residential care settings; few countries are specifically reporting data on infections and deaths among users of home care – an exception to this is Australia; overall evidence of national measures to support community-based care is still lacking for most countries.

Last updated on hub: 04 November 2020

Older and ‘staying at home’ during lockdown: informal care receipt during the COVID-19 pandemic amongst people aged 70 and over in the UK

SocArXiv

On 23 March 2020 the UK went into lockdown in an unprecedented step to attempt to limit the spread of coronavirus. Government advice at that time was that all older people aged 70 and over should stay at home and avoid any contact with non-household members. This study uses new data from the Understanding Society COVID 19 survey collected in April 2020, linked to Understanding Society Wave 9 data collected in 2018/19,in order to examine the extent of support received by individuals aged 70 and over in the first four weeks of lockdown from family, neighbours or friends not living in the same household, and how that support had changed prior to the outbreak of the coronavirus pandemic. The research distinguishes between different types of households as given with guidance not to leave home and not to let others into the household, those older people living alone or living only with a partner also aged 70 and above are more likely to be particularly vulnerable. The results highlight both positive news alongside causes for concern. The receipt of assistance with Instrumental Activities of Daily Living(IADLs), especially shopping, has increased particularly among those living alone or with an older partner, reflecting the rise of volunteering and community action during this period. However, not all older people reported a rise, and the majority reported ‘no change’, in the support received. Moreover, amongst those older people reporting that they required support with at least one Activity of Daily Living (ADL) task prior to the pandemic, around one-quarter reported receiving no care from outside the household and one-in-ten of those with two or more ADL care needs reported receiving less help than previously. Although formal home care visits have continued during the pandemic to those who have been assessed by the local government to be in need, it is important to acknowledge that some older people risk not having the support they need.

Last updated on hub: 17 November 2020

Overview of feedback from the social care sector: CIW check-in calls with providers of registered services for adults and children

Care Inspectorate Wales

This document provides an overview of the CIW ‘check-in’ calls from 30 March until 26 July where inspectors had 10,045 conversations with registered social care services in Wales about how they were managing the impact of COVID-19. The main themes drawn from responses are: the importance of a rights-based approach, ensuring people receiving social care, and their families or advocates, are involved in decision making; recognising, and minimising as far as possible, the impact not being able to see family and friends has on the mental well-being of many people; the importance of having a co-ordinated communication strategy that minimises duplication and clearly highlights key issues and changes to guidance; ongoing access to infection prevention and control training and support; ensuring easy access to sufficient personal protective equipment (PPE), with clarity about its use; ensuring easy access to testing with a timely turnaround of results; the importance of support networks for managers and care workers recognising the isolation of the many small providers in Wales; the importance of continuity of staffing because of increased risk of agency staff transmitting the virus if they are working across different services; and recognising that providers are partners in care especially in relation to hospital discharge, as are family members, for many people.

Last updated on hub: 02 February 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

Personal protective equipment (PPE): care workers delivering homecare during the Covid-19 response

Healthcare Safety Investigation Branch

This national intelligence report provides insight into a current safety risk that the Healthcare Safety Investigation Branch (HSIB) has identified, relating to the use of personal protective equipment (PPE) by care workers when visiting a patient at home. It documents how concerns raised by HSIB were responded to by Public Health England, the body responsible for the development of guidelines for the appropriate use of PPE. The report finds that there are multiple Covid-19 guidelines for different care sectors. PPE guidelines should be used in conjunction with other guidelines, such as infection control guidelines, so that care providers can develop protocols for care delivery. This is challenging when guidelines are updated, or new guidelines are issued and there is a risk that guidance may be missed. The report argues that there is an opportunity to introduce a document management system for guidelines to ensure that the latest information is available. This would involve the design of a usable navigation system so that all related guidelines relevant to a particular care sector are visible and can be checked for completeness.

Last updated on hub: 01 September 2020

Personal protective equipment (PPE): resource for care workers delivering domiciliary care during sustained COVID-19 transmission in England

Public Health England

Guidance for those working in domiciliary care providing information on the use of personal protective equipment (PPE) during sustained coronavirus (COVID-19) transmission in England. It explains how PPE guidance applies to the homecare (domiciliary care) setting and is drawn from full infection prevention and control (IPC) and PPE guidance. The guidance is primarily for care workers and providers delivering care in visiting homecare, extra care housing and live-in homecare settings. [Published 27 April 2020; Last updated 5 July 2021]

Last updated on hub: 20 April 2021

Personal protective equipment (PPE): resource for care workers delivering homecare (domiciliary care) during sustained COVID-19 transmission in the UK

Public Health England

Guidance for those working in domiciliary care providing information on the use of personal protective equipment (PPE) during sustained coronavirus (COVID-19) transmission in the UK. It explains how PPE guidance applies to the homecare (domiciliary care) setting and is drawn from full infection prevention and control (IPC) and PPE guidance. The guidance is primarily for care workers and providers delivering care in visiting homecare, extra care housing and live-in homecare settings. [Published 27/04/202. Last updated 17/08/2021]

Last updated on hub: 28 April 2020

Pilot point prevalence survey of COVID-19 among domiciliary care staff in England

Public Health England

This pilot study provides the first estimate of the extent of COVID-19 infections among domiciliary care workers in England. A prospective descriptive survey of a sample of workers from domiciliary care providers was carried out in June 2020, using a sampling frame of all care providers in England registered with CQC. The findings provide evidence that the prevalence of COVID-19 among domiciliary care workers is in line with the general population as opposed to a higher prevalence as observed in studies of front-line healthcare workers and care home staff. It should be noted that this study took place post the peak of the first wave of the COVID-19 pandemic and as a result its findings are not directly comparable to those emerging from care home and healthcare worker studies.

Last updated on hub: 16 July 2020

Preventing and managing COVID-19 across long-term care services: policy brief

World Health Organization

This briefing provides policy objectives and key action points to prevent and manage COVID-19 across long-term care settings. The brief builds on currently available evidence on the measures taken to prevent, prepare for and respond to the pandemic across long-term care services including care providers. COVID-19 has affected older people disproportionately, especially those living in long-term care facilities. In many countries, evidence shows that more than 40% of COVID-19 related deaths have been linked to long-term care facilities, with figures being as high as 80% in some high-income countries. Concerted action is needed to mitigate the impact across all aspects of long-term care, including home- and community-based care, given that most users and providers of care are those who are vulnerable to severe COVID-19. Specifically, the paper argues that the following policy objectives should be pursued to mitigate the impact of COVID-19 across long-term care: include long-term care in all phases of the national response to the pandemic; mobilise adequate funding; ensure effective monitoring and evaluation of the impact of COVID-19 on long-term care; secure staff and resources, including adequate health workforce and health products; ensure the continuum and continuity of essential services for people receiving long-term care; ensure that infection prevention and control standards are implemented and adhered to in all long-term care settings; prioritise testing, contact tracing and monitoring of the spread of COVID-19 among people receiving and providing long-term care services; provide support for family and voluntary caregivers; prioritise the psychosocial well-being of people receiving and providing long-term care services; ensure a smooth transition to the recovery phase; and initiate steps for the transformation and integration of health and long-term care systems.

Last updated on hub: 27 July 2020

Princess Homecare: collaborative working and maintaining quality

Princess Homecare

Practice example about how Princess Homecare, a small domiciliary care agency in Wiltshire has coped during the COVID-19 pandemic. This includes the support provided by the Council and how they have kept a log of actions and activities taken due to COVID-19 Also covers some of the key challenges and learning points to date.

Last updated on hub: 16 July 2020

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