COVID-19 resources on Infection control

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Mortality associated with COVID-19 in care homes: international evidence

International Long-term Care Policy Network

This document focuses on mortality associated with COVID-19 in care homes, summarising information from three types of sources: epidemiological studies, official estimates and news reports; and relies on national experts for confirmation of sources and definitions. Key findings include: official publicly available data on the numbers of deaths among care home residents linked to COVID-19 is not available in many countries; international comparisons are difficult due to differences in testing capabilities and policies, different approaches to recording deaths, and differing definitions of what constitutes a “care home”; there are three main approaches to quantifying deaths in relation to COVID-19: deaths of people who test positive (before or after their death), deaths of people suspected to have COVID-19 (based on symptoms or epidemiologically linked), and excess deaths (comparing total number of deaths with those in the same weeks in previous years); another important distinction is whether the data covers deaths of care home residents or only deaths in the care home; based on the data gathered for this report, the current average of the share of all COVID-19 deaths that were care home residents is 46% (based on 21 countries); the share of all care home residents who have died (linked to COVID-19) ranges from 0.01% in South Korea to over 4% (which would mean that over one in 25 care home residents have died linked to COVID-19) in Belgium, Ireland, Spain, the UK and the US; currently, there is limited evidence from anywhere in the world on how individuals who receive care in the community have been directly or indirectly affected by COVID-19.

Last updated on hub: 04 November 2020

Moving practice online: knowledge exchange for social service practitioners adapting to the covid -19 context

A summary of responses to a knowledge exchange held with social service practitioners in New Zealand on how they were adapting their practice to ensure physical distancing during the coronavirus (Covid-19) pandemic. Practitioners described many ways that their processes, practices and technologies were changing in order to continue their work. The document provides a brief overview paragraph summarising each area of practice adaptation and a list of ideas from practitioners. Four areas of practice adaptation are covered: engaging in direct practice - including managing potential risks related to heightened family stresses and the possibilities of family violence; managing service user pathways, including managing new referrals; ethical and cultural issue, such as balancing user needs with the need to reduce the spread of the virus; and staff issues relating to staff protections, work practices that reduce spread of the virus.

Last updated on hub: 07 May 2020

National Care Forum COVID-19 guidance and resources

National Care Forum

The COVID-19 section of the National Care Forum (NCF) website is a good source for government guidance and information relevant to the care sector. The resource includes links to information about: infection control, CPA Visitors’ Protocol, clinical guidance, regulation, information governance, workforce, supported housing and homeless, volunteering wellbeing and other practical resources.

Last updated on hub: 20 August 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

National discussions on mandatory vaccination for long-term care staff in 24 countries

International Long-term Care Policy Network

Following the enormous impacts of Covid-19 among people who use long-term care, most countries have prioritised people who live and work in care homes for vaccinations. In some countries there is also a debate on whether it should be compulsory for people working in this sector (or particularly in care homes) to be vaccinated, or whether there are other measures that may be more acceptable and effective at increasing vaccination take-up and may not deter people from working in the sector. This post provides an overview of the situation in May 2021 in 24 countries. This review finds that most countries have stated that staff working in long-term care would be among the first groups to be prioritized for Covid-19 vaccinations but in many countries there have been practical difficulties in facilitating access to vaccination for this group which, added to some vaccine hesitancy, has resulted in lower vaccination rates for staff than ideal. Vaccines are mandatory for healthcare personnel in Italy. While many countries have debated whether to make Covid-19 vaccinations mandatory for certain groups, including people working in long-term care, none of the 24 countries for which we have information have adopted this as a national policy, although there are some local/regional examples where this has become the practice or where providers require that their employees are vaccinated. There are a few examples of other vaccinations (such as flu) being made mandatory for staff working in long-term care and/or health care. Most countries do not have data systems that support monitoring of vaccination rates among staff working in the long-term care sector.

Last updated on hub: 16 June 2021

New analysis finds the pandemic has significantly increased older people’s need for social care

Age UK

New Age UK analysis finds that the experience of living through the fear, enforced isolation and inactivity caused by the pandemic has sharply accelerated the care needs of significant numbers of older people.

Last updated on hub: 25 May 2021

NICE guidance: preventing infection and promoting wellbeing

Skills for Care

This webinar – delivered by NICE – focuses on two areas of NICE guidance: helping to prevent infection and promoting positive mental wellbeing, considering the particular challenges for social care during the COVID-19 pandemic. The webinar also covers NICE COVID-19 rapid guidelines and NICE social care quick guides.

Last updated on hub: 29 June 2020

Nontraditional small house nursing homes have fewer COVID-19 cases and deaths

Journal of the American Medical Directors Association

Objectives: Green House and other small nursing home (NH) models are considered “nontraditional” due to their size (10–12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer people living, working, visiting, and being admitted to Green House/small NHs, and private rooms and bathrooms, but this assumption has not been tested. If they prove advantageous compared with other NHs, they may constitute an especially promising model as policy makers and providers reinvent NHs post-COVID. Design: This cohort study compared rates of COVID-19 infections, COVID-19 admissions/readmissions, and COVID-19 mortality, among Green House/small NHs with rates in other NHs between January 20, 2020 and July 31, 2020. Setting and Participants: All Green House homes that held a skilled nursing license and received Medicaid or Medicare payment were invited to participate; other small NHs that replicate Green House physical design and operational practices were eligible if they had the same licensure and payer sources. Of 57 organizations, 43 (75%) provided complete data, which included 219 NHs. Comparison NHs (referred to as “traditional NHs”) were up to 5 most geographically proximate NHs within 100 miles that had <50 beds and ≥50 beds for which data were available from the Centers for Medicare and Medicaid Services (CMS). Because Department of Veterans Affairs organizations are not required to report to CMS, they were not included. Methods: Rates per 1000 resident days were derived for COVID-19 cases and admissions, and per 100 COVID-19 positive cases for mortality. A log-rank test compared rates between Green House/small NHs and traditional NHs with <50 beds and ≥50 beds. Results: Rates of all outcomes were significantly lower in Green House/small NHs than in traditional NHs that had <50 beds and ≥50 beds (log-rank test P < .025 for all comparisons). The median (middle value) rates of COVID-19 cases per 1000 resident days were 0 in both Green House/small NHs and NHs <50 beds, while they were 0.06 in NHs ≥50 beds; in terms of COVID-19 mortality, the median rates per 100 positive residents were 0 (Green House/small NHs), 10 (<50 beds), and 12.5 (≥50 beds). Differences were most marked in the highest quartile: 25% of Green House/small NHs had COVID-19 case rates per 1000 resident days higher than 0.08, with the corresponding figures for other NHs being 0.15 (<50 beds) and 0.74 (≥50 beds). Conclusions and Implications: COVID-19 incidence and mortality rates are less in Green House/small NHs than rates in traditional NHs with <50 and ≥50 beds, especially among the higher and extreme values. Green House/small NHs are a promising model of care as NHs are reinvented post-COVID.

Last updated on hub: 03 March 2021

Novel coronavirus (COVID19) standard operating procedure: COVID-19 vaccine deployment programme: frontline social care workers (JCVI Priority Cohort 2)

NHS England

This standard operating procedure (SOP) outlines the process for facilitating COVID-19 vaccination for frontline social care workers (excluding those working in care homes for older adults) as defined by the JCVI. This includes the identification of eligible care workers and the roles and responsibilities within local systems for enabling and supporting care workers to be vaccinated. The SOP also outlines how Hospital Hubs, Vaccination Centres and Local Vaccination Services should work to deliver COVID-19 vaccination to frontline social care workers at pace. It covers how they should work in partnership to match vaccination capacity to meet demand, support booking, on the day arrangements and data capture to monitor uptake. It does not cover the clinical delivery of the vaccine, which is covered in separate guidance.

Last updated on hub: 19 January 2021

Nursing home design and COVID-19: balancing infection control, quality of life, and resilience

Journal of the American Medical Directors Association

Many nursing home design models can have a negative impact on older people and these flaws have been compounded by Coronavirus Disease 2019 and related infection control failures. This article proposes that there is now an urgent need to examine these architectural design models and provide alternative and holistic models that balance infection control and quality of life at multiple spatial scales in existing and proposed settings. Moreover, this article argues that there is a convergence on many fronts between these issues and that certain design models and approaches that improve quality of life, will also benefit infection control, support greater resilience, and in turn improve overall pandemic preparedness.

Last updated on hub: 07 December 2020

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