COVID-19 resources on Infection control

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Personal protective equipment (PPE) recommendation for unpaid carers

UK Health Security Agency

This resource outlines personal protective equipment (PPE) advice for unpaid carers. Unpaid carers should ensure they wear the correct PPE for the situation in which they are providing care. It sets out four examples of situations that they might encounter. For each it describes the PPE that they should wear. 1. When they are within 2 metres of the person you are caring for who has COVID-19 or flu like symptoms such as coughing, high temperature or loss of taste or smell; 2.When providing personal care, involving potential contact with blood or body fluids; 3.When they are within 2 metres of a person you are caring for and contact with blood or body fluids is not likely; 4.When they are more than 2 metres from the person they are caring for and undertaking domestic duties.

Last updated on hub: 13 December 2021

Living with dementia during the COVID-19 pandemic: coping and support needs of community-dwelling people with dementia and their family carers. Research findings from the IDEAL COVID-19 Dementia Initiative (IDEAL-CDI)

University of York

This report sets out findings from the IDEAL COVID-19 Dementia Initiative (IDEAL CDI), which was established to identify concerns and issues faced by people living with dementia and their carers as a result of the coronavirus epidemic and the strict social restrictions imposed in England between March and June 2020. The report is based on interviews with people with dementia and carers from the IDEAL cohort. Some people with dementia coped well, while others coped with difficulty or were only just coping. The additional stress of COVID-19 exacerbated pre-existing coping difficulties. For many, social isolation increased anxiety. Some felt that lack of activity or lack of social contact caused a decline in their abilities to manage everyday tasks. Confusion about COVID-19 rules or difficulty remembering what to do led to anxiety when leaving the house. People felt that members of the public might not understand their particular needs. While some carers felt they were coping well, others experienced stress when having to leave the home because the person with dementia might not be safe if left alone. Some experienced increased strain in the caring relationship compounded by an uncertainty about future availability of respite. Some were concerned about the complex health needs of the person with dementia alongside COVID-19 risk and lack of personalised information. Both people with dementia and carers talked about the importance of access to safe outdoor space. People were anxious about how others would react or behave towards them regarding keeping a distance if they went out. Being connected to friends, family and wider community or support groups was important to help combat the effects of isolation. People from BAME communities worried about their increased vulnerability to the virus. A lack of trust in Government guidance and in health care services added to their anxiety. However, some benefitted from strong community and faith group involvement.

Last updated on hub: 07 December 2021

Mitigating the impact of SARS-CoV-2 on residential facilities for persons with intellectual disability and/or autism spectrum disorder: two experiences from the Italian red zone

Advances in Mental Health and Intellectual Disabilities

Purpose: Persons with intellectual disability and/or low-functioning autism spectrum disorder are with high support need (ID/ASD-HSN) are among the people who are most vulnerable to the COVID-19 pandemic. The specific vulnerability and the protective factors for persons with ID/LF-ASD attending residential and rehabilitative facilities have however received little attention. This paper aims to describe how two facilities located in the Italian COVID-19 red zone faced the risks associated with the spread of the pandemic and the results they have achieved so far. Design/methodology/approach: Interventions to contrast the spread of the pandemic and preserve clients’ health conditions have been systematically monitored and recorded since the very beginning of the pandemic. Findings: 26/138 clients had to undergo clinical screening and laboratory tests for COVID-like symptomatology, but only one resulted affected by COVID-19 and survived. Considering that Lombardy had 89,595 cases and 16,262 deaths (January–May 2020), one COVID-19 case/138 clients is a good result. Temporarily limiting physical contacts with friends/family in favor of reducing the burden of risk and adopting a system of prevention/safety strategies directed for persons with ID/LF-ASD attending and their caregivers have been useful measures. Research limitations/implications: Structured or semi-structured interviews (using professional caregivers as informant) to confirm behavioral and emotional changes in the clients could not be carried out because of lack of time and resources (which were captured by the management of the pandemic) and could be the next goal for our residential facilities to implement the management of epidemic acute phases in a research-oriented view. Originality/value: This study is a service evaluation report about facing COVID-19 pandemic. Only few such studies are present in medical literature about ID/ASD.

Last updated on hub: 03 December 2021

COVID-19 management in social care in England: a systematic review of changing policies and newspaper reported staff perspectives


Adult social care has been a major focus of public attention and infection control guidance during the COVID-19 pandemic, with a high mortality both for carers and those receiving care. To protect themselves and others from infection, staff in residential and domiciliary care settings had to quickly adapt to infection control measures that heavily impacted on their working and every-day life, whilst navigating new responsibilities, uncertainties and anxieties. This study sought to explore the production and reception of guidance and look at ways these can be adapted to improve the working life of care staff in domiciliary and residential care whilst reducing the risk of SARS-CoV-2 transmission amid this pandemic and of future emerging infections. The researchers conducted two complementary and integrated systematic reviews of published documents in the pre-vaccination era: (1) National guidance for social care (conducted between 29 July to 28 October 2020), and (2) Newspaper coverage of infection control issues in social care (conducted between 27th July to 10th September 2020). Three higher order common themes emerged in the integrated systematic review of guidance documents and newspaper articles: a) Testing, b) Personal Protective Equipment, c) Employment. The reviews revealed a sharp disjunction between the content of infection control guidance and its usability and applicability in social care settings. This study suggests that infection control guidance needs to be better adapted to social care settings and informed by the sector. The practicalities of care work and care settings need to be at the core of the process for guidance to be relevant and effective. Modes and timings of communications also need to be optimised. [Note: This article is a preprint and has not been certified by peer review. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.]

Last updated on hub: 29 November 2021

Understanding vaccine hesitancy through communities of place: abridged report

Institute for Community Studies

This report presents a summary of the longer study ‘Vaccine Hesitancy and Communities of Place’. The study looked at the issue of vaccine engagement with historical and sociological lenses. It has delved into the health, social, economic, and political consequences of COVID-19 for different groups in each of the case study areas and also examined the historic and current dynamics of the relationship between different communities and a) health authorities; b) local authorities and State authorities; c) organisations and groups. The study has found how the interaction of place with the social determinants of health has created antecedent conditions for vaccine hesitancy in certain communities. Some critical lessons can be learnt from this report, namely: addressing vaccine hesitancy requires the engagement of national, State and local institutions with local communities in an authentic manner over time to build trusting relationships; messaging about COVID-19 should be straightforward and transparent, and grounded in pull - not push - reasons for accepting the vaccine, that may be locally specific; messages should be delivered in conversations between trusted “messengers” and local residents, and should consider their rationales, concerns and fears about vaccination, recognising that they are real regardless of the source; vaccine delivery should be associated with activities and materials that people want and need, including access to dialogue about their health, and health education; local organisations and convening efforts in communities as well as public health authorities should have reliable and accessible local and hyperlocal data able to be disaggregated by demographics and vaccine variables on an ongoing basis, that provide for agile planning in emergency and ‘peace-time’ public health approaches for different local communities.

Last updated on hub: 24 November 2021

Supporting excellence in infection prevention and control behaviours: implementation toolkit

Department of Health and Social Care

This implementation toolkit is designed to provide information, resources and ideas, to adult social care providers, to address the barriers to behavioural excellence with infection prevention and control (IPC) measures. The toolkit has been developed to support adult social care providers to use the 'Every Action Counts' suite of resources effectively. The suite comprises posters, digital key cards and hints and tips, supporting compliance and awareness, leadership, morale and wellbeing, training and operational interventions. Innovative ideas to support interventions have also been collated from the research and included at the end of this document.

Last updated on hub: 23 November 2021

IPC good practice guide: an introduction from the Chief Nurse for Adult Social Care

Department of Health and Social Care

This guide focuses on infection prevention and control (IPC) good practice. It includes good practice examples for care home and domiciliary care workers, and for infection control teams. There are also two case studies of good practice from infection control teams. Themes covered include: embedding a culture of safety; good hand hygiene; good PPE use; good communication; examples of supporting each other; examples of good ventilation practice; specialist infection control nursing providing support for Adult Social Care; and good training and learning.

Last updated on hub: 23 November 2021

COVID-19 in long-term care: impact, policy responses and challenges

Organisation for Economic Co-operation and Develop

The COVID-19 crisis has hit the long-term care (LTC) sector particularly hard, with large numbers of people dependent on care and particularly vulnerable to COVID-19 have fallen ill, and a disproportionate rate of LTC workers both exposed to, and infected by, COVID-19. The analysis presented in this report describes the effects of COVID-19 on LTC in OECD countries, mainly showing infection rates and mortality of LTC recipients. It takes stock of the wide range of policy responses that countries have implemented, detailing the changes over time on testing strategies, reduction of interactions and isolation measures, digitalisation of services, and workforce. The report also assesses emergency preparedness in the sector, as well as workforce, organisational and coordination challenges. Finally, the report analyses how policy responses affected care continuity and the well-being of residents while also outlining the effectiveness of vaccination.

Last updated on hub: 22 November 2021

Residents' and relatives' experiences of returning to visiting Leeds care homes: summary report June-August 2021

Healthwach Leeds

This summary report outlines overall findings and recommendations based on 200 responses to a survey of relatives and residents from a total of 50 Leeds care homes on their experiences of returning to visiting. The vast majority of relatives said their care home was enabling unsupervised indoor visiting without a screen, and that they were able to hold hands if they wished. There was a lot of variation in terms of how often relatives were able to visit and how long they were able to stay – some care homes were still restricting visits to 30 minutes an hour, whilst others had removed time limits and relatives could visit as often as they wanted. Only 25% of respondents whose loved one didn’t have the mental capacity to make decisions around visiting were able to confirm that a family member had been involved in expressing their wishes and needs on their behalf. 68% of relatives and residents responding to the survey said that they felt that the visiting options available met their or their loved ones’ needs. The main reasons people gave for visiting not meeting their needs were: people weren’t able to visit often enough, and visits were too short; people felt that visiting in a ‘visiting room’ didn’t meet their loved one’s needs and that they would like to be able to visit them in their own room; where residents had dementia or sensory loss, some relatives said that wearing a mask made communication difficult. Good regular communication was really valued by families, both in terms of visiting and general updates about the home. It was also important to them to be kept up to date about how their loved one was, including being involved in regular reviews of their care plan.

Last updated on hub: 22 November 2021

Comparative analysis of variation in the quality and completeness of local outbreak control plans for SARS-CoV-2 in English local authorities

Journal of Public Health

Background: Local outbreak control plans (LOCPs) are statutory documents produced by local authorities (LAs) across England. LOCPs outline LAs’ response to Coronavirus Disease 19 (COVID19) outbreaks and the coordination of local resources, data and communication to support outbreak response. LOCPs are therefore crucial in the nation’s response to COVID-19. However, there has been no previous systematic assessment of these documents. We performed this study to systematically assess the quality of LOCPs and to offer recommendations of good practice. Methods: All published LOCPs were assessed for basic characteristics. A framework based on Department of Health and Social Care guidelines was used to assess a random sample of LOCPs. Qualitative analysis was undertaken for LOCPs with highest completeness. Results: Hundred and thirty-seven of 150 LAs publicly published a full LOCP; 9 were drafts. Statistical analysis demonstrated the significant difference between reporting of mainstream schools, care homes and the homeless population and other educational settings, high-risk settings and other vulnerable groups. LOCPs varied in approach when structuring outbreak response information and focused on different areas of outbreak management. Conclusions: The majority of LAs are publicly accessible. There is significant variation between the reporting of high-risk settings and groups. Suggested recommendations may help to improve future LOCP updates.

Last updated on hub: 19 November 2021

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