COVID-19 resources on Infection control

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Overview of adult social care guidance on coronavirus (COVID-19)

Department of Health and Social Care

Brings together information for adult social care providers on COVID-19 guidance and support. The resource covers help with infection prevention and control; what to do when you suspect an outbreak; reporting an outbreak; caring for patients discharged from hospital or another social care facility; visits to care homes and other care settings; information for providers of care in supported living and domiciliary settings; how to get social care workers and people in care homes tested; managing care workers during COVID-19; securing PPE and related supplies; help for holders of direct payments, commissioners and care providers; information for social care providers on mental health and wellbeing and financial support; Capacity Tracker and guidance on using it; information for unpaid carers; easements of the Care Act; COVID-19 ethical framework for adult social care; caring for people who are protected by safeguards under the Mental Capacity Act 2005, including the deprivation of liberty safeguards; steps to take following a coronavirus-related death of a person who worked in adult social care. [First published 25 August 2020; Last updated 23 June 2021]

Last updated on hub: 27 August 2020

Ownership and COVID-19 in care homes for older people: a living systematic review of outbreaks, infections, and mortalities


Background The adult social care sector is being increasingly outsourced to for-profit providers, but the impacts of privatisation on service quality and resident outcomes are unclear. During the COVID-19 pandemic, for-profit providers have been accused of failing their residents by prioritising profits over care, prevention, and caution, which has been reported to result in a higher prevalence of COVID-19 infections and deaths in for-profit care homes. Although many of these reports are anecdotal or based on news reports, there is a growing body of academic research investigating ownership variation across COVID-19 outcomes, which has not been systematically appraised and synthesised. Objectives To identify, appraise, and synthesise the available research on ownership variation in COVID-19 outcomes (outbreaks, infections, deaths, shortage of personal protective equipment (PPE) and staff) across for-profit, public, and non-profit care homes for older people, and to update the findings as new research becomes available. Design Living systematic review. Methods This review was prospectively registered with Prospero (CRD42020218673). The researchers searched 17 databases and performed forward and backward citation tracking of all included studies. Search results were screened and reviewed in duplicate. Risk of bias (RoB) was assessed in duplicate according to the COSMOS-E guidance. The results were synthesised according to RoB, model adjustment, and country context and visualised using harvest plots. Results Twenty-eight studies across five countries were included, with 75% of included studies conducted in the Unites States. For-profit ownership was not consistently associated with a higher probability of COVID-19 outbreaks across included studies. However, there was compelling evidence of worse COVID-19 outcomes following an outbreak; with for-profit care homes having higher rates of accumulative infections and deaths. For-profit providers were also associated with shortages in PPE, which may have contributed to the higher incidence of infections and deaths. Chain affiliation was often found to be correlated with higher risk of outbreaks, but not consistently associated with an elevated number of deaths and infections. Private equity ownership was not consistently associated with worse COVID-19 outcomes. Conclusion For-profit status was a consistent risk factor for higher cumulative COVID-19 infections and deaths. Thus, ownership among providers may be a key modifiable factor which can be regulated to improve health outcomes in vulnerable populations and reduce health disparities. This review will be updated as new research becomes published, which may change the conclusion of the synthesis.

Last updated on hub: 25 February 2021

Pandemic Patient Experience II: from lockdown to vaccine roll-out

Patients Association

This report outlines the findings of an online survey conducted from February 11th to April 5th 2021, following up key themes in our report of last year, Pandemic Patient Experience. The survey reveals that the struggles to access services that many patients experienced in the spring and summer of 2020 have been less severe since then, but have still continued to some extent. Many people have shielded during the pandemic, but most shielding has not been done in line with official advice. The impact of shielding, and the numbers of people who will find it hard to return to participating fully in society, may therefore be widely underestimated. Patient feedback on the vaccination programme is extremely positive. Most patients found communication about their vaccine appointment and the process for arranging it very positive. Patients’ views on the overall handling of the pandemic were somewhat mixed. Very few rated it as very good, but across the other response options there was a range of opinion, trending overall to the negative. Vaccinated respondents were clearly more likely to rate it positively than unvaccinated respondents, but this may simply reflect a well documented trend in views across age groups rather than people’s views being specifically influenced by whether or not they have had a vaccination.

Last updated on hub: 04 May 2021

Participants at adult day services centers and their caregivers

Centers for Disease Control and Prevention

Adult Day Services Centers (ADSCs), also known as adult day services or adult day care, provide social or health services to adults 65 and older living in communities and to adults of any age living with disability. Participants (adults who attend ADSCs) and their caregivers can also take steps to protect themselves and their loved ones by helping reduce the spread of COVID-19 at ADSC facilities and at home.

Last updated on hub: 19 April 2021

Partners in care: resources to support meaningful visits

National Care Forum

This set of resources is designed to provide practical support to care homes and their relatives and loved ones to adopt the default position that care homes are open for visiting. Care homes must be supported to enable and welcome visits by families and friends, now and in the future. It is clear that we must find a way to resolve the challenge of visiting in care homes for the longer term; we are facing a world where we will have to live with COVID-19 for the foreseeable months and indeed years. This means reaching an agreed partnership position, with practical measures, rights and responsibilities that enables visiting long term rather than the current cycle of crisis short term approaches. The National Care Forum has worked with care providers and residents and relatives organisations to develop these Partners in Care resources to support meaningful visits. It includes: a Visiting Charter – sets out a shared set of rights and responsibilities; a Visiting Pledge – covers key commitments that all parties can sign up to; and useful practical resources to support the charter and the pledge.

Last updated on hub: 22 March 2021

Patients living with dementia who ‘walk with purpose or intent’ in the COVID-19 crisis

NIHR Applied Research Collaboration (ARC) West

This evidence summary looks at how to manage care home residents with dementia who ‘walk with purpose or intent’ such that infection prevention measures are not breached during an epidemic such as COVID-19. It identified clear guidance from the British Geriatric Society (BGS) on the approach of care home staff for residents with dementia who ‘walk with purpose or intent’ during the COVID 19 crisis. The guidance focuses on isolation of suspected cases and behavioural approach to ameliorating potential unsafe activities of residents. The British Psychological Society’s Faculty of the Psychology of Older People also describes primary preventative and secondary reactive behavioural approaches that can be used to care for residents during the COVID 19 outbreak.

Last updated on hub: 10 June 2020

People and places in London most vulnerable to COVID-19 and its social and economic consequences

New Policy Institute

This report identifies groups of people whose socio-economic status puts them at higher risk of either catching COVID-19 or passing it on, experiencing harm to their health and wellbeing during lockdown; or experiencing harm as both lockdown and the emergency measures introduced to alleviate it, are lifted. The report is divided into four sections, looking at people and households who face higher risks as a result of: COVID-19 itself and the wider pandemic; the economic recession; housing insecurity; and having pre-existing additional support needs. Built around a set of statistical indicators, the report offers a picture of the scale of vulnerability and how it varies across London boroughs. Half the indicators show the background (pre-pandemic) position and half show how things have changed since March 2020. Four of the 29 indicators are restricted to London (or London subregions) while one is national. The report’s main message is that the vulnerabilities flowing from the pandemic and the accompanying recession affect more and different people than those who are usually seen as vulnerable. While the need to protect older people from the virus remains paramount, the report concludes that the pandemic and recession should be seen as a crisis for people of working-age, especially those in the 20s, 30s and 40s, and their children.

Last updated on hub: 10 March 2021

Personal assistants eligible for vaccination as part of national priority group two: frontline social care workers

Local Government Association

These questions and answers document has been developed with leading organisations and individual councils working to support take-up of vaccination among frontline social care workers. To be eligible for vaccination in the national priority group two, personal assistants need to be caring for someone who is clinically extremely vulnerable to COVID-19, and/or has a defined underlying health condition leading to greater risk of disease or mortality from COVID-19, and/or is of advanced age (85+); this is set out in detail in the Standard Operating Procedure (SOP) published on 14 January 2021. Topics areas include: eligibility and the process for getting vaccinated; data sharing; employment-related questions; unpaid carers; and vaccinations for people being cared for by a PA.

Last updated on hub: 03 March 2021

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

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