COVID-19 resources on infection control

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Long-stay mental health care institutions and the COVID-19 crisis: identifying and addressing the challenges for better response and preparedness

World Health Organization

This report presents the results of a survey with 169 long-stay institutions to assess the impact of the COVID-19 pandemic on services, staff, service users and residents with psychosocial and intellectual disabilities. Specific themes explored in this report are how well the institutions were prepared for the crisis by authorities, the quality of communications, the availability of personal protective equipment, and the impact of the risk of infection and protective measures on staff and residents. The report finds that there were significant differences between the types of institution reporting, which included psychiatric hospitals; care homes; and other settings for mental health care. Responses from psychiatric, intellectual disability and autism services were broadly consistent with those from social care homes, except for the following significant areas of difference: social care homes were happier with information from the authorities and the information they provided for residents in accessible formats; care home staff reported challenges with more workload, stress, frustration and burnout; care homes were less likely to use discharge to reduce numbers and manage the virus; and more likely to report an increase in the use of restrictive measures. The analysis highlights the need to put in place comprehensive and practical plans to facilitate management and day-to-day operations under crisis conditions. The keys to this are: having clear guidelines and tested systems in place; ensuring clarity of communication; implementing a comprehensive and facility-based infection prevention and control plan; establishing clear procedures and protocols to ensure safe environments; being able to increase staff capacities according to need; and having a clear focus on ensuring person-centred and human rights-based care in all decision-making.

Last updated on hub: 05 October 2020

Delivering core NHS and care services during the pandemic and beyond: second report of session 2019–21

UK Parliament

Findings of an inquiry to investigate a range of issues relating to the delivery of core NHS and care services during the pandemic. This report addresses the following issues: communication with patients; managing waiting times and the backlog of appointments; issues facing NHS and care staff relating to access to personal protective equipment (PPE) and routine testing of staff; issues facing NHS and care staff relating to workforce “burnout”; and what lessons can be learnt from the pandemic in order to support the NHS in the future. The coronavirus pandemic posed an unprecedented challenge to the NHS and social care system. The report raises concerns about the lack of effective communication strategies with patients; the substantial increase in the number of missed, delayed and cancelled appointments across critical non-COVID services; and the effect of the pandemic on the physical and mental wellbeing of the NHS and social care workforce. The report also assesses what changes should take place to support the NHS in the long-term. They include introducing an expanded 111 dial service to support A&E departments, investigating how technology (“telemedicine”) can be used without digitally excluding those already disadvantaged, and retaining capacity and resources from the independent sector in the long term.

Last updated on hub: 05 October 2020

As if expendable: the UK government’s failure to protect older people in care homes during the Covid-19 pandemic

Amnesty International UK

This report examines the impact of decisions, policies, and decision-making processes at the national and local level on the human rights of older people in care homes in England in the context of the COVID-19 pandemic. It is based on interviews with 18 relatives of older people who either died in care homes or are currently living in care homes in different parts of England; nine owners, managers and staff of care homes in different parts of the country; eight staff and volunteers working in non-profit organisations advocating on behalf of care home residents and staff; three members of parliament and local authorities, and four legal and medical professionals. Among the government’ failures, the report highlights discharge of patients from hospitals into care homes; denial of access to hospitals and other medical services; misuse of ‘do not attempt resuscitation’ (DNAR) forms; inadequate access to testing; insufficient PPE and poor PPE guidance; poor, late and contradictory guidance; and failure to respond to gaps in staffing. The report also discusses the suspension of visits and failure of oversight, including the failure to wear PPE, challenges of remote communications and the devastating impact of prolonged isolation. The report argues that the UK government’s response to the COVID-19 pandemic violated the human rights of older people in care homes in England and that remedial action must be taken without delay to ensure that mistakes are not repeated. It calls for a full independent public inquiry to consider the overall pandemic preparations and response in adult social care and care homes, including a full investigation into actions taken to ensure a comprehensive and timely cross-government response for social care and a review of the adequacy of the funding made available to support adult social care services and care homes in responding to the pandemic.

Last updated on hub: 05 October 2020

Crises collide: women and Covid-19: examining gender and other equality issues during the Coronavirus outbreak

Women’s Budget Group

This report outlines issues relating to women and Covid-19 in the UK and makes recommendations for gender-sensitive improvements to the UK Government’s response. It focuses on the implications of the pandemic for women in relation to public health, social care, economic inequalities, social security, housing, violence against women and girls, the justice system and human rights. 73% of Covid-19 critical care cases in England, Wales and Northern Ireland are men. However, growing evidence shows that due to pre-existing gender and other inequalities, different groups of women in the UK will experience Covid-19 in specific ways in the short, medium and long term. The report finds that women are the majority of health and care workers and are the majority of workers with highest exposure to Covid-19; young women are disproportionately likely to work in the sectors that have been hit hardest by the lock-down; women are more likely to be low paid and in insecure employment and are the majority of people living in poverty and female-headed households are more likely to be poor; pre Covid-19, women were more likely to struggle with debt and bills; on average, women carry out 60% more unpaid work than men; women are more likely to experience domestic and sexual violence and abuse and are the majority (67%) of people living in homelessness.

Last updated on hub: 01 October 2020

Delivering care at home and housing support services during the COVID-19 pandemic: Care Inspectorate inquiry into decision making and partnership working

Care Inspectorate Scotland

This report draws together the views of health and social care partnerships and service providers in Scotland about their experience of care at home and housing support services during the first phase of this pandemic. It sets out the findings of a Care Inspectorate’s inquiry which investigated how these services were prioritised to help ensure service delivery continuity; what were the known impacts on people who experience care; how the risks to service delivery were mitigated; how effective were the partnership working arrangements; and what were the recovery plans for services. The inquiry found that the most robust responses to the challenges and uncertainties of the pandemic involved an integrated approach and included: targeting resources to meet gaps and pressures as they occurred and reviewing and refining approaches as new information came to light; maintaining a focus on how staff remained confident, safe and secure by addressing the challenges of PPE, guidance and testing; responding quickly with additional financial support and guarantees to ensure services remained viable and that the commitment was not undermined by unpredictable reductions in income and additional costs; investing in staff terms and conditions to reduce disincentives to testing and self-isolating when required; and working together across health and social care, service providers and the community.

Last updated on hub: 30 September 2020

Potential impact of COVID-19: government policy on the adult social care workforce

Institute for Employment Studies

This report is the output of a research project to identify how government COVID-19 related policy may have impacted upon the adult social care workforce in England. The project had a particular focus on Test and Trace, and the ways in which policy changes may have enabled and incentivised the necessary behaviours of care workers. The working hypothesis has been that care workers’ behaviours are likely to be driven by a combination of commitment to those they care for, risks to themselves and their families from COVID-19 and impacts on incomes. Government policy changes were identified based on the assumed likelihood to impact on these factors. The key findings and observations include: the fragmented nature of the sector is likely to make it challenging to get information and support to the people that need it, and therefore ensure that the desired behaviour changes are happening; government guidance and measures appear to have been rushed, heavily focused on care homes and their workers, and impossible to find in one place on the internet; testing has been hard to access – this has been a disincentive to get tested, as is the fear of being unable to work if testing positive; a major concern for individuals is loss of income if having to rely on Statutory Sick Pay. The report makes recommendations for further research into the actual impact of policy on the workforce and suggestions for improving policy development, communication and implementation.

Last updated on hub: 29 September 2020

Lived experience: voices of older people on the COVID-19 pandemic 2020

Age NI

This report highlights the experiences of older people in Northern Ireland living through the COVID-19 pandemic. Drawing on feedback from the Consultative Forum at Age NI, it reflects key concerns and experiences through four key themes: support, health and care; communication and connection; loneliness and isolation; and grief and loss. The report finds that the pandemic and lockdown forced changes to many of the everyday care and support systems older people depend upon –restrictions on acute and community services made managing existing health concerns more difficult for many older people. Accessing sources of clear, up to date information has been very important during the lockdown – older people would like to access support and services online; they have concerns about using public transport for getting out and about again; and want safe ways to get back to their interests and activities. Older people are especially vulnerable to the effects of loneliness – older people shielding and not able to maintain movement and activity lost physical and cognitive fitness rapidly; and lack of connection and being unable to visit care homes caused some to worry about the risk of abuse and neglect. The COVID-19 pandemic is responsible for a significant increase in the number of excess deaths in Northern Ireland and older people feature disproportionately among them – families were distressed and concerned when advanced care planning was raised during the early stages of the pandemic; and people were worried and anxious about older people living in residential and nursing homes. The report provides a set of specific action points to help improve older people’s experience in relation to each of the four themes.

Last updated on hub: 28 September 2020

Impact and mortality of COVID-19 on people living with dementia: cross-country report

International Long-term Care Policy Network

This report brings together international evidence on the impact of the COVID-19 pandemic on people living with dementia and an overview of international policy and practice measures to mitigate the impact of COVID-19 among people living with dementia. It draws on data from nine countries: United Kingdom (UK), Spain, Ireland, Italy, Australia, the United States (US), India, Kenya and Brazil. The analysis indicates that the share of people whose deaths were linked to COVID-19 in care homes who had dementia ranges from 29% to 75% across those countries. Within countries, people with dementia account for 25% of all COVID-19 related deaths in England and Wales, 31% in Scotland and 19% in Italy. In many places, the basic human rights of people with dementia may have been compromised during the pandemic. These rights include access to Intensive Care Units, hospital admissions, health care and palliative care. The controversial ban on visits (including spouses and care partners) to care homes across the world, have kept people with dementia detached from essential affective bonds and provision of family care for many months. The report argues that guidance and tools to support institutions and practitioners to respond better to the needs of people with dementia during the pandemic are needed as a matter of urgency. Confinement, isolation and many of the challenges brought about by the pandemic are detrimental to the cognitive and mental health symptoms in people with dementia across the world, both those living in the community and care homes. This report offers a list of short-term and long-term actions needed to ensure that people with dementia are not being left behind in this pandemic or future ones.

Last updated on hub: 28 September 2020

Adult social care winter plan: letter from Minister for Care to local authorities

Department of Health and Social Care

Letter from Helen Whately, Minister for Care, to outline the expectations of local authorities in relation to the adult social care winter plan. The plan sets out the actions the Government is taking at a national level to support those who provide and receive care. It also outlines the actions every local area (local authorities and NHS partners) and every care provider must take to support the collective efforts to keep the coronavirus at bay.

Last updated on hub: 28 September 2020

National Care Forum infection, prevention and control (IPC) compliance assessment tool

National Care Forum

This compliance assessment is a simple tool which has been developed using the most recent information on infection prevention and control (IPC) from the CQC and others. It will help care providers know how well they are doing, identify areas in which they need to improve and bring the guidance together into one place. This completion of an assessment using this tool will also provide the evidence that they need to satisfy the CQC requirements and will help ensure services are prepared and in a strong position to manage any ‘second wave’ of COVID-19, or indeed, other yet unknown pressures. There are 8 sections to the tool covering the management of visitors, social distancing, admissions, PPE, testing, premises, staffing and policy. Each section contains a description of what is important to consider and examples of evidence that could be seen as good practice.

Last updated on hub: 28 September 2020

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