COVID-19 resources on Infection control

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Coronavirus: adult social care key issues and sources

House of Commons Library

This briefing provides an overview of key issues facing the adult social care sector in England during the coronavirus (Covid-19) pandemic, and provides links to some of the main official guidance for the sector. Section one provides a high-level overview of policy in relation to adult social care since the start of the Covid-19 outbreak in early 2020. The remaining sections provide more detailed information on some key issues that have arisen during the course of the pandemic, including: statistics on deaths in care homes; funding for adult social care, including the financial pressures on social care providers; testing for care home staff and residents; the discharging of patients from hospitals into care homes; rules relating to visiting care homes during the pandemic; the supply of PPE to the adult social care sector; the policy of mandatory vaccination of social care workers.

Last updated on hub: 01 February 2022

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

Misconduct in public office: why did so many thousands die unnecessarily?

This report sets out the findings and recommendations of The People’s Covid Inquiry, which took place fortnightly from 24 February to 16 June 2021. A panel of four, chaired by Michael Mansfield QC, heard evidence from over 40 witnesses including bereaved families, frontline NHS and key workers, national and international experts, trade union and council leaders, and representatives from disabled people’s and pensioners’ organisations. The Inquiry considered: how well prepared was the NHS; how the government responded; whether the Government adopted the right public health strategy; impact on the population: bereaved families, care homes and older people, palliative care, disabled people, children and young people, and schools; impact on frontline staff; inequalities and discrimination; profiteering from the people’s health; and governance of the pandemic. The Inquiry found that the NHS was not well prepared for the pandemic. The UK COVID-19 death toll need not have been so high. The straitened circumstances of the NHS were an important contributor to what transpired. Furthermore, The failure to recognise and address health determinants has led to a decline in the health of the UK population, a widening of health inequalities, and the consequent increased burden of COVID-19 mortality and morbidity falling upon the most disadvantaged sections of society. The spread of the pandemic, and the death toll was also worsened by a poor public health response – the consequence of over a decade of reduced funding, loss of expertise, dissipation of services, and multiple reorganisations.

Last updated on hub: 19 January 2022

Changes in COVID-19 outbreak severity and duration in long-term care facilities following vaccine introduction, England, November 2020 to June 2021

Eurosurveillance

This study describes the impact of changing epidemiology and vaccine introduction on characteristics of COVID-19 outbreaks in 330 long-term care facilities (LTCF) in England between November 2020 and June 2021. As vaccine coverage in LTCF increased and national incidence declined, the total number of outbreaks and outbreak severity decreased across the LTCF. The number of infected cases per outbreak decreased by 80.6%, while the proportion of outbreaks affecting staff only increased. The study supports findings of vaccine effectiveness in LTCF.

Last updated on hub: 06 January 2022

Contact tracing for COVID-19: the use of motivational interviewing and the role of social work

Clinical Social Work Journal

One method in mitigating the impact of COVID-19 is that of contact tracing. It is estimated that in the US, 35,000–100,000 contact tracers will be hired (and trained) to talk to recently-infected individuals, understand who they have exposed to the virus, and encourage those exposed to self-quarantine. The Center for Disease Control recommends the use of motivational interviewing (MI) by contact tracers to encourage compliance with contact tracing/quarantine. Contact tracers need to sensitively communicate with COVID-19-exposed individuals who may also be experiencing other issues caused by the pandemic, such as anxiety, depression, grief, anger, intimate partner violence, health problems, food insecurity, and/or unemployment. Social workers are particularly prepared to address the mental health and other psychosocial problems that may be encountered in the tracing process. This article describes contact tracing, its use in other diseases, the role of MI, psychosocial issues that contact tracers may encounter, and how social work can respond to these needs. A sample dialogue of contact tracing using MI is presented with a discussion of the content and skills used in the process.

Last updated on hub: 23 December 2021

The lived experience of implementing infection control measures in care homes during two waves of the COVID-19 pandemic. a mixed-methods study

Journal of Long-Term Care

Context: During COVID-19 care-homes had to implement strict Infection Control Measures (ICMs), impacting on care and staff morale. Objectives: To explore the lived experiences of care-home staff in implementing ICMs. Methods: Mixed-methods study comprising 238 online survey responses and 15 in-depth interviews with care-home staff, November 2020-January 2021 in England. Results: Three themes were identified: ‘Integrating COVID-19 ICMs with caring’, ‘Conveying knowledge and information’, ‘Professional and personal impacts of care-work during the pandemic’. Reported adherence to ICMs was high but fatalistic attitudes towards COVID-19 infection were present. Challenges of providing care using personal protective equipment (PPE), especially for residents with dementia, were highlighted. Interviewees reported dilemmas between strictly implementing ICMs and conflicts with providing best care to residents and preserving personal space. Nine months into COVID-19, official guidance was reported as confusing, constantly changing and poorly suited to care-homes. Care-home staff appreciated opportunities to work with other care-homes and experts to interpret and implement guidance. ICM training was undertaken using multiple techniques but with little evaluation of these or how to sustain behaviour change. Limitations: Results may not be generalizable to other countries. Implications COVID-19 has had a profound effect on well-being of care-home staff. Despite challenges, participants reported broadly good morale, potentially a consequence of supportive colleagues and management. Nevertheless, clear, concise and care-home focussed ICM guidance is still needed. This should include evidence-based assessments on implementing and sustaining adherence. Groups of care-home staff and ICM experts working together to co-create, interpret and implement guidance were viewed positively.

Last updated on hub: 23 December 2021

CG report 6: effects of COVID-19 in care homes – a mixed method review

University of Oxford

This report provides an up-to-date review of the global effects of the COVID-19 pandemic in care homes. The review used a mixed methods approach to assess care home mortality by country, how the deaths compared with previous periods, and how excess deaths may be explained. The study included national datasets for 25 countries on mortality, 17 cohort studies assessing deaths compared to a previous period, and 16 cohort studies reporting interventions or factors associated with excess mortality. Analysis of national datasets for 25 countries shows that care home deaths were, on average, 30% of the total COVID-19 deaths (range: 9-64%). The 17 cohort studies also point to excess mortality worsening during the pandemic, with excess mortality being reported for both COVID-19 positive and negative patients. Several reported interventions or factors suggest the potential to mitigate the risk in care homes substantially. Interventions that could reduce mortality include improving the care home quality, increasing staffing levels, reducing the number of beds in the facility, employing staff confinement strategies with residents, and improving clinical care such as implementing daily examinations. Some care home solutions like US ‘Green House’ homes, which usually have fewer than 12 beds, may provide crucial insights into the care home problem compared with larger homes. Conclusion: the scale of the problem in care homes requires robust evaluation and coordinated strategies to improve outcomes for those most vulnerable to COVID-19. Failure to address these systemic problems could mean global care home populations will be similarly affected by future crises and pandemics.

Last updated on hub: 23 December 2021

Infection prevention and control in nursing homes during COVID-19: an environmental scan

Geriatric Nursing

To examine processes and programmatic elements of infection prevention and control (IPC) efforts and identify themes and promising approaches in nursing homes (NHs), an environmental scan was conducted. Data sources included a literature search, relevant listservs and websites, and expert consensus based on a virtual summit of leaders in IPC in long-term care settings. Three thematic areas emerged which have the potential to improve overall IPC practices in the long-term care setting: staffing and resource availability, training and knowledge of IPC practices, and organizational culture. If improved IPC practices and reduced cross-transmission of infections in NHs are to be sustained, both short-term and long-term changes in these areas are essential to fully engage staff, build trust, and enhance a ‘just’ organizational culture.

Last updated on hub: 21 December 2021

Coronavirus (COVID-19) test kits for children's homes

Department for Education

Sets out when to test children and staff, type of test that should be used, and how to order more COVID-19 tests for children's homes settings. This guidance supports children’s homes in using and ordering polymerase chain reaction (PCR) test kits and lateral flow device (LFD) tests. Covers the testing options for both open children’s homes and secure children's homes. Updated on 20 December 2021 to reflect that daily testing is now recommended for contacts of COVID-19. [First published 14 December 2020. Last updated 20 December 2021]

Last updated on hub: 21 December 2021

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