COVID-19 resources on Infection control

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Adult social care in England (COVID-19): a review of the 2020 to 2021 winter plan and subsequent actions – what more should be done?

Department of Health and Social Care

This review has evaluated the policies and initiatives put in place to support the adult social care sector this winter, both those in the adult social care (COVID-19) winter plan (published in September 2020) and those introduced later. The winter plan set out the key elements of national support available for the social care sector for winter 2020 to 2021, as well as the main actions to take for local authorities, NHS organisations, social care providers and the CQC, including in the voluntary and community sector. The revies focuses on supporting the workforce; vaccination; funding and resources; supporting people who receive social care and their carers, including digital support and addressing inequalities; collaboration across health and care services. The review found that stakeholders offered broad support for all of the additional funding packages announced, noting it was crucial in allowing them to overcome the additional burdens placed on them by the pandemic, but felt that the funding received was insufficient, and that funding announcements came too late and was often too short term. Stakeholders were impressed with the efforts to ensure that care home visiting, both inward and outward, is made available to all residents in care homes with measures to mitigate the risk. As we progress through the roadmap and facilitate more interactions between different services, particular attention should be given by adult safeguarding boards, regional and national assurance, and regulation that sufficient measures are in place to deal with situations of potential concern, including safeguarding. Furthermore, stakeholders noted that the needs of unpaid carers have increased during the pandemic, yet the support offered to them by both state and voluntary providers has been curtailed. The report incudes a set of 33 recommendations.

Last updated on hub: 08 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

Open with care: supporting meaningful contact in care homes

Scottish Government

This guidance applies to all adult care homes, which are now asked to make arrangements to enable meaningful contact with residents and loved ones. Given each care home has different circumstances to take into account, this guidance allows appropriate local flexibility as we continue to fight the global pandemic. Care homes and relatives are asked to work together thoughtfully and constructively in the short period while preparations and adaptions are put in place. The guidance states that care homes should work to increase the frequency and duration of meaningful contact with residents. In the first instance, resuming indoor visiting should involve up to two designated visitors weekly, visiting one at a time. This should however be seen as the minimum starting point with consideration given to increasing the number of visitors and frequency of visiting, as and when the care home judges it is safe to do so, with expert advice and support from oversight arrangements where appropriate.

Last updated on hub: 08 November 2021

Open with care: care home managers feedback on implementation survey findings

Scottish Government

Findings from an online survey of care home managers to provide feedback to the Scottish Government on their experiences of implementing the Open with Care visiting guidance, and help to inform future planning and guidance to support the sector. The guidance supports meaningful contact to resume between adult care home residents and their loved ones, beginning with visiting up to twice a week. This guidance is now possible due to all the COVID-protections in place. A total of 434 responses were received between 30th July and 15th August 2021. Main findings include: the majority of respondents were supporting a range of visiting options and were planning to continue to increase contact for residents and their families and friends; respondents viewed visiting as vitally important for residents and their loved ones, and they were striving to deliver meaningful contact safely; however, it was clear that respondents were dealing with substantial logistical challenges and sensitive issues around visiting, within the context of balancing safety and risk, and were very concerned about future outbreaks and potential repercussions; the majority of respondents were experiencing significant challenges in relation to staffing and workload; for some respondents, ensuring visitor compliance with guidance was a further challenge; there were mixed views about the advice, guidance and support provided for Open with Care with calls for more notice to be given around significant guidance changes and suggestions for improving the clarity of guidance.

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

Strengthening population health and local economies by involving directors of public health

King's Fund

This policy paper draws on research on how Directors of public health (DsPH) and their teams have been central to the Covid-19 response. Is sets out the lessons and implications for how others – including local authority chief executives, public health decision-makers, and integrated care system (ICS) leads with a focus on population health and health inequality reduction – work with and support public health. DsPH and their teams have become more influential in their local systems, moving beyond role boundaries. There has been a greater understanding of the role and expertise of DsPH and public health teams in local health and care systems. Relationships between DsPH and chief executives of local authorities have been mutually beneficial. Covid-19 has shown the expertise and contribution of DsPH beyond the confines of the public health grant and health protection issues; there is a renewed opportunity to move towards a health-inall-policies approach across local government and stronger integration between health and economic policy. The Covid-19 pandemic has shown how DsPH and public health teams understand their places and communities in a deep and granular way. Their knowledge and expertise need could help ICSs design interventions for those with, and reach those who are at greater risk of, poor outcomes and health inequalities. Finally, Covid-19 has shown that public health approaches and actions need to be increasingly integrated at national, regional and local levels: this should be a priority for the United Kingdom Health Security Agency, the Office for Health Improvement and Disparities, and the NHS.

Last updated on hub: 03 November 2021

Directors of public health and the Covid-19 pandemic: ‘a year like no other’

King's Fund

The Covid-19 pandemic has been an unprecedented situation that has tested local public health systems to the extreme for more than a year. Directors of public health (DsPH) in particular have had a unique viewpoint and have been at the forefront of making complex decisions about their local populations. In this research (supported by the Health Foundation), we undertook 58 interviews with DsPH and other leaders working at local, regional and national levels. We found DsPH have played a crucial role in leading the local response to Covid-19. They have been responsible for a wide range of health protection activities from testing in the community, to facilitating the uptake of the vaccine, to planning for the availability of food and emotional support for local people. The report highlights key learning from the experiences of DsPH to build a picture of what has happened over the past year and what is important for a strong public health response to the recovery from the pandemic and any future public health emergencies. Our study highlighted two key aspects to directors’ involvement in responding to Covid-19. First was their formal role in the local public health system; they helped guide and shape the response within regional and local emergency structures and committees. And second was the striking role that DsPH played more broadly in engaging local communities, facilitating vital social support and acting as a linchpin within the broader response. The challenges they faced included workforce shortages within public health teams and not being properly engaged by central government regarding major elements of the overall response to Covid-19; key enablers were the ability to exploit existing relationships as well as directors’ ability to build new connections, and to bring people together from different parts of the system.

Last updated on hub: 03 November 2021

Caring from a distance: what can we learn from carers' experiences of using new and familiar ways to stay in touch with family and friends in care homes during COVID-19?

University of Hull

This study explored the experiences of families and friends of care home residents during the closure of care homes during the COVID-19 pandemic, with a specific focus on how they worked to maintain contact with their relative/friend, the approaches which worked well as well as those which were unsuccessful. Keeping in touch with people in care homes can be important both for family carers/friends and care home residents. Throughout the pandemic, carers, residents and care homes have tried new ways of keeping in touch. Different strategies for keeping in touch were discussed by carers. These included new ways of being in contact (for example, using technology), as well as more familiar ways (such as the phone and post). All of the methods worked really well for some people, and were unsuccessful and distressing for others. A key message from this research is that there is no single ‘best’ way to keep in touch from a distance. Instead, it is important to find the right method for the resident and their carer. This is often referred to as having a personalised approach; this should be part of residents’ care plans, and reviewed and updated regularly. It was clear from the findings that keeping in touch from a distance was very challenging for some care home residents, and it had not always been possible to find good ways of managing this for everyone. The research also highlighted the importance of support from staff and managers for keeping in touch alongside care homes having good resources, such as access to technologies and good internet connections, as well as having other ‘low-tech’ resources available, such as adapted phones which can be used by people with sensory impairments or physical disabilities.

Last updated on hub: 02 November 2021

Staying ‘Covid-safe’: proposals for embedding behaviours that protect against Covid-19 transmission in the UK

British Journal of Health Psychology

Objectives: The Scientific Pandemic Insights group on Behaviours (SPI-B) as part of England’s Scientific Advisory Group on Emergencies (SAGE), were commissioned by the UK Cabinet Office to identify strategies to embed infection control behaviours to minimize Covid-19 transmission in the long term. Methods: With minimal direct evidence available, three sources of information were used to develop a set of proposals: (1) a scoping review of literature on sustaining behaviour change, (2) a review of key principles used in risk and safety management, and (3) prior reports and reviews on behaviour change from SPI-B. The information was collated and refined through discussion with SPI-B and SAGE colleagues to finalize the proposals. Results: Embedding infection control behaviours in the long-term will require changes to the financial, social, and physical infrastructure so that people in all sections of society have the capability, opportunity, and motivation needed to underpin those behaviours. This will involve building Covid-safe educational programmes, regulating to ensure minimum standards of safety in public spaces and workspaces, using communications and social marketing to develop a Covid-safe culture and identity, and providing resources so that all sections of society can build Covid-safe behaviours into their daily lives. Conclusions: Embedding ‘Covid-safe’ behaviours into people’s everyday routines will require a co-ordinated programme to shape the financial, physical, and social infrastructure in the United Kingdom. Education, regulation, communications, and social marketing, and provision of resources will be required to ensure that all sections of society have the capability, opportunity, and motivation to enact the behaviours long term.

Last updated on hub: 01 November 2021

Exploring older people’s experiences of shielding during the COVID-19 pandemic

Trinity College Dublin

The aim of this study was to identify older people’s experiences of shielding during the COVID19 pandemic; to explore older people’s experiences of shielding as a public health measure; to identify the personal circumstances of shielding (i.e. alone/family); to identify facilitators and challenges within the period of shielding; to elicit any consequences of shielding (physical/psychological/social); and to consider any lessons which are important considerations if shielding of older people is necessary as a future public health measure. A total of 20 interviews were conducted ranging between 15 to 52 minutes. Participants included 8 males and 12 females ranging in age from 59 years to 92 years. The study found that older people made substantial changes to their daily lives to comply with the COVID-19 shielding guidance; COVID-19 had significant impacts on the health of older people in the community; social capital was demonstrated as compensatory measures were adopted to daily lives; older people reported a general stoic approach to living in the pandemic and they demonstrated resilience in multiple ways; the use of technology assisted in managing social and practical activities, however, its use, satisfaction and familiarity differed within the participants in the study; older people need more integrated support systems which maintain their personal, health and social needs; consideration needs to be given to pandemic related information to avoid information fatigue, misinformation, and confusion; post-pandemic rehabilitation will be required to focus on restoring lost physical ability and address the consequences of social isolation and loneliness; there is a need to ensure that ageist approaches do not underpin guidance; the rights of autonomy and self-determination need to be central considerations in future similar crises.

Last updated on hub: 01 November 2021

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