COVID-19 resources on Infection control

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Personal assistants returning from shielding

Mark Bates Ltd

Fact sheet offering support to people who employ personal assistants with regards to their employee returning to work, following the lifting of shielding measures by the Government.

Last updated on hub: 04 August 2020

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

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

Public Health England

This guidance provides advice for care workers working in care homes on the use of personal protective equipment (PPE) during the period of sustained transmission of the coronavirus (COVID-19). The guidance is also relevant for those providing residential supported living. This resource, which has been designed to be accessible to both care workers and providers, has four sections containing: recommendations on the use of PPE for a range of relevant contexts; explanation concerning recommendations and frequently asked questions; specialist advice relating to care for people with learning disabilities and/or autism; and case scenarios designed to illustrate appropriate use of PPE in practice. It should be read in conjunction with the full infection prevention and control (IPC) and PPE government guidance. [Published 17 April 2020; Last updated 18 May 2021]

Last updated on hub: 23 June 2020

Perspectives from the front line: the disproportionate impact of COVID-19 on BME communities

NHS Confederation

This report distils the findings of a research study into the underlying factors affecting the disproportionate impact of Covid-19 on black and minority ethnic (BME) communities. It is based on interviews with BME NHS leaders, clinicians, community organisations and service users, and a survey of over 100 members of the NHS Confederation’s BME Leadership Network. Topics covered include: inequalities and health; institutional racism; racial discrimination on the front line; communication; and the Black Lives Matter movement. Overwhelmingly, participants point to long-standing inequalities and institutional racism as root causes. Interviewees were united in the view that despite the wealth of data collected by the national bodies and numerous reviews on the relationship between health, inequalities and BME communities, the NHS and government had not taken sufficient action to address the underlying issues. To redress this, it will be crucial to treat long-term structural health inequities and institutional racism as critical factors when planning services and emergency responses. To break down barriers to accessing healthcare, the government should take immediate steps to review the potential for hostile environment policies to be a vehicle for promoting institutional racism. BME health and care professionals were reported to be more likely to take on high-risk roles, including working on COVID-19 wards, due to fear that contracts may not be renewed or shifts reduced – this was compounded by a bullying culture which meant that BME employees were less likely to raise concerns or share their experiences. The report argues that the health service should look to adopt a new model of leadership that welcomes and values innovators with roots in BME communities and a track record of anti-racism. Integrated care systems should lead the development of governance and human resources functions that facilitate diverse leadership in line with commitments in the NHS People Plan.

Last updated on hub: 04 January 2021

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

Point of care testing using rapid automated antigen testing for SARS-COV-2 in care homes – an exploratory safety, usability and diagnostic agreement evaluation

medRxiv

Introduction Successful adoption of POCTs (Point-of-Care tests) for COVID-19 in care homes requires the identification of ideal use cases and a full understanding of contextual and usability factors that affect test results and minimise biosafety risks. This paper presents findings from a scoping-usability and test performance study of a microfluidic immunofluorescence assay for COVID-19 in care homes. Methods A mixed-methods evaluation was conducted in four UK care homes to scope usability and to assess the agreement with qRT-PCR. A dry run with luminescent dye was carried out to explore biosafety issues. Results The agreement analysis was carried out on 227 asymptomatic participants (159 staff and 68 residents) and 14 symptomatic participants (5 staff and 9 residents). Asymptomatic specimens showed 50% (95% CI: 1.3%-98.7%) positive agreement and 96% (95% CI: 92.5%-98.1%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.911 (95% CI: 0.857-0.965). Symptomatic specimens showed 83.3% (95% CI: 35.9%-99.6%) positive agreement and 100% (95% CI: 63.1%-100%) negative agreement with overall prevalence and bias-adjusted Kappa (PABAK) of 0.857 (95% CI: 0.549-1). The dry run showed four main sources of contamination that led to the modification of the standard operating procedures. Simulation after modification showed no further evidence of contamination. Conclusion Careful consideration of biosafety issues and contextual factors associated with care home are mandatory for safe use the POCT. Whilst POCT may have some utility for ruling out COVID-19, further diagnostic accuracy evaluations are needed to promote effective adoption.

Last updated on hub: 06 May 2021

Policy briefing: the COVID-19 vaccination and unpaid carers (England only)

Carers UK

Unpaid carers are included in the priority lists for the COVID-19 vaccine in the same way that they are for the flu jab. This briefing sets out the position in more detail and explores recommendations for deployment of the vaccine to unpaid carers in detail.

Last updated on hub: 13 January 2021

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