COVID-19 resources on Infection control

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The Health Service and Social Care Workers (Scrutiny of Coronavirus-related Deaths) Directions 2020

Department of Health and Social Care

These directions ensure that NHS trusts and NHS foundation trusts seek and prioritise the services of medical examiners to scrutinise the deaths of health service and adult social care staff from coronavirus. Examiners are required to consider whether there is reason to suspect that the death was a result of the person being exposed to coronavirus during the course of their NHS or social care work

Last updated on hub: 13 July 2020

The impact of COVID-19 lockdown measures on the physical health of people living with severe mental illness

Rethink Mental Illness

This briefing looks at the impact of the Covid-19 pandemic on the physical health of people living with severe mental illness (SMI), based on the responses to a survey of 1,434 people. The briefing highlights key findings and outlines concerns about the implications of lockdown restrictions on people with severe mental illness, who already die on average 15 to 20 years earlier than the general population. Over half of respondents have been exercising less and eating less healthily during lockdown and said they were eating less healthily than usual. Respondents reported that they were smoking (16%) and drinking (23%) more than usual and a small proportion also said they were using more illicit drugs (3%) – these were likely used as coping strategies or to alleviate boredom. The paper recommends reinstating physical health checks for people with SMI and relevant system targets; co-producing targeted communications with people severe mental illness; gathering lessons from the implementation of the Community Mental Health Framework; addressing the needs of those with SMI in the government emerging obesity strategy linked to COVID-19.

Last updated on hub: 06 July 2020

The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: a retrospective population-based cohort study for mortality in 2016–2020

Age and Ageing

Background: mortality in care homes has had a prominent focus during the COVID-19 outbreak. Care homes are particularly vulnerable to the spread of infectious diseases, which may lead to increased mortality risk. Multiple and interconnected challenges face the care home sector in the prevention and management of outbreaks of COVID-19, including adequate supply of personal protective equipment, staff shortages and insufficient or lack of timely COVID-19 testing. Aim: to analyse the mortality of older care home residents in Wales during COVID-19 lockdown and compare this across the population of Wales and the previous 4 years. Study Design and Setting: we used anonymised electronic health records and administrative data from the secure anonymised information linkage databank to create a cross-sectional cohort study. We anonymously linked data for Welsh residents to mortality data up to the 14th June 2020.Methodswe calculated survival curves and adjusted Cox proportional hazards models to estimate hazard ratios (HRs) for the risk of mortality. We adjusted HRs for age, gender, social economic status and prior health conditions. Results: survival curves show an increased proportion of deaths between 23rd March and 14th June 2020 in care homes for older people, with an adjusted HR of 1.72 (1.55, 1.90) compared with 2016. Compared with the general population in 2016–2019, adjusted care home mortality HRs for older adults rose from 2.15 (2.11, 2.20) in 2016–2019 to 2.94 (2.81, 3.08) in 2020. Conclusions: the survival curves and increased HRs show a significantly increased risk of death in the 2020 study periods.

Last updated on hub: 21 January 2021

The impact of Covid-19 on community health services

NHS Confederation

This report captures the community sector’s response during the pandemic and showcases the achievements of community providers and their staff. Community health services play a key role within the health and care system, supporting integration at place and neighbourhood level through their relationships across the spectrum of local health and care organisations, including primary care, social care, local authorities and voluntary, community and social enterprise (VCSE). They keep people well at home, or in community settings as close to home as possible, and support them to live independently. The report seeks to learn from community providers’ experiences of the pandemic to secure the necessary transformation for the longer term. It suggests that the expansion and transformation of community services’ capacity during the pandemic proved critical in supporting the NHS’s response. As the health and care sector moves to recover and reset after the first peak of the outbreak, community service providers are now embedding innovative practice. They will play a critical role in providing ongoing rehabilitation for people who have been most seriously ill from the virus. The paper calls for investing in public health and place the social care system on a sustainable footing as a priority; supporting investment in home-based community pathways as well as community rehabilitation beds; boosting the community workforce with a national recruitment campaign and increased deployment of returners before winter pressures hit; and creating a digital improvement strategy, robust national dataset and national performance standards to standardise and spread best practice.

Last updated on hub: 10 August 2020

The impact of COVID-19 on kinship care: evidence from the kinship care charity Grandparents Plus

Scottish Journal of Residential Child Care

The challenges faced by children in kinship care and their families have been regularly identified in research. Kinship carers look after for some of society’s most vulnerable children, usually whilst facing many adversities themselves. The COVID-19 global pandemic had a significant impact on kinship carers, placing additional stress on their already difficult situations. This article describes the work of Grandparents Plus, the leading charity for kinship care in England and Wales, to identify the impact of COVID-19 on kinship carers and ensure they continued to receive support. Data were gathered using three surveys of kinship carers in England and Wales, and through discussions with Grandparents Plus project workers and volunteers. Kinship carers reported feeling scared about catching the virus, and what would happen to the children if they fell seriously ill. They were exhausted caring for the children twenty-four hours a day without a break and they were worried about the uncertainties of living with a ‘new normal’. Grandparents Plus used this information to develop new and existing support services to meet kinship carers’ needs in the context of COVID-19. It is concluded that kinship carers need sustained support to develop resilience to protect against future unforeseen crises.

Last updated on hub: 06 October 2020

The impact of COVID-19 on long-term care in Canada: focus on the first 6 months

Canadian Institute for Health Information

This report explores the pandemic experience in long-term care (LTC) and how it compares between provinces and territories in Canada. The first part of the report presents early comparisons between the first and second waves in both LTC and retirement homes. The second part focuses on the first 6 months of the pandemic in LTC homes specifically, where older Canadians with the most complex health care needs reside. It examines: the impact of COVID-19 on LTC residents and staff; changes in how residents received care; and key recommendations from investigations and inquiries of LTC homes to date. The report finds that: LTC and retirement homes have been disproportionately affected by COVID-19 in Canada, and the pandemic experience has not improved overall for the sector in the second wave; LTC residents received less medical care during the first wave of COVID-19 than in normal years; the number of LTC resident deaths was higher than usual during the first wave of the pandemic; recommendations from provincial and national inquiries to date on COVID-19 in LTC homes are similar and speak to structural challenges in the sector. This includes the need for increased staffing levels, stronger infection control and prevention practices, better inspection and enforcement processes, and improved building infrastructure to reduce crowding and infection spread.

Last updated on hub: 19 April 2021

The impact of Covid-19 on nursing homes in Italy

Politecnico di Milano

This brief note examines the interplay between the institutional context of care homes in Italy and the spread of the pandemic. As they faced the pandemic, care homes had both internal and external problems. On the internal side, they had to face the entry of the virus into their structures with inadequate medical staff and insufficient resources and capacity to implement distancing and other preventive actions. They were also unable to provide adequate health care to their Covid-19 patients, and very often unable to send them to hospitals. On the external side, their situation was ignored for a long time by policy makers, who were mainly focused to face the emergency in hospitals. The national lockdown of nursing homes regarding the access of relatives and external visitors – a crucial measure in order to prevent possible transmission of infection – was established only on March 4, about two weeks later the spreading of the infection. Furthermore, for many weeks not adequate attention has been paid to testing and monitoring activities among healthcare staff and patients: a priority for the implementation of such preventive activities in nursing homes was established only at the beginning of April. The paper argues that most of the criticalities came from the pre-existent difficult condition of these institutions. The more nursing homes have specialised in the intensive-health treatment of seriously non-self-sufficient elderly, the more the quality of their services had been hampered by very precarious financial and organisational conditions, co-determined by the lack of public investment in these structures. The pandemic has acted as a “focusing event”, revealing the structural weakness of this sector and the main critical problems affecting it.

Last updated on hub: 11 November 2020

The impact of the coronavirus (Covid-19) on people who work as social care personal assistants

King's College London

This study addresses the impact of the Covid-19 pandemic on the work of social care Personal Assistants supporting people in need of care and support. Drawing from a sample of 105 PAs, researchers were able to interview 41. The findings show that regardless of whether they were paid, unless they were themselves ‘shielding’ to protect themselves or a family member, nearly all PAs were helping others in some way on a voluntary basis. However, other than limited, general guidance from the government which was not always thought useful by PAs, there were few other reliable sources of information about the virus, or about practical arrangements such as when and where to get tested, to obtain Personal Protective Equipment (PPE), and to learn safe practices. Most PAs wore masks, gloves, aprons and said it was likely to become routine practice for them now, but It was often difficult for them to obtain PPE. PAs were asked about what would be most helpful to them in responding and adapting to the Covid virus. Several suggestions were made, including ready access to sufficient quantities of good quality PPE; the implementation of easily accessible, reliable testing; effective mechanisms for contact tracing to help prevent the spread of the virus; a single source of contact for support and reliable and accurate advice; better pay, contracts and less precarious working conditions; and financial support to people who were unable to work, but were not being paid by the employer, and did not qualify for the government’s furlough scheme.

Last updated on hub: 23 September 2020

The impact of the COVID-19 pandemic on adults with learning disabilities and / or autism, their family carers and service provision: a rapid learning review

Association of Directors of Adult Social Services

This report aims to reflect and build on the work of ADASS regions in supporting people living with learning disabilities and / or autism, and their carers during the COVID pandemic. It is a rapid qualitative review, using semi-structured interviews and a roundtable event to capture professional perspectives after a year of exceptional challenges. A strong view emerged that the early stages of the national COVID-19 social care response was driven exclusively by a focus on older adults living in care homes – people with learning disability or autism were perceived to be an after-thought by government, reflected in the lateness and fragmentary nature of national guidance, testing and PPE relating to these groups of adults. This was considered a reflection of the long-standing weaker policy focus on this community more generally. As social care and health staff were redeployed into different roles, a gap was exposed in the knowledge, skills and competencies around learning disability, autism and neurodiversity across the general social care, health care and housing workforce. The loss of contact with friends, daily activities and routines has exacerbated pre-existing health and wellbeing challenges for people with learning disabilities and / or autism. Increases in (or new) anxiety and depression were reported, alongside boredom and frustration. Market development was highlighted as a priority issue in numerous interviews, with the initial focus on reshaping day opportunities and short-breaks / respite. The recurring theme was to achieve a shift away from building-based support to buildings used as hubs/pods and / or increasing the availability of outreach. This was seen as a collaborative process with providers to diversify and flex what it is possible to offer for adults with learning disabilities or autism, including the development of micro-providers/PAs.

Last updated on hub: 24 May 2021

The impact of the Covid-19 pandemic on Approved Mental Health Professional (AMHP) services in England

British Association of Social Workers

Based on responses to a survey from 100 Approved Mental Health Professional (AMHP) services across England, which account for 75% of the local authorities across the country, this report explores the impact of the Covid-19 pandemic on mental health professionals and services. The survey questions focused on changes in demand for Mental Health Act (MHA) assessments both during the first lockdown and following the easing of restrictions, the possible reasons for the changes and the impact of the pandemic and the resulting restrictions on staff. Most respondents reported an increase in assessments overall, particularly during the lockdown period and into the post-lockdown period in summer. This amounts to a higher level of demand than prior to the pandemic. Many services identified a significant increase in ‘first-time presentations’ of people who had not been previously known to mental health services. Concern was expressed from many respondents that withdrawal of face-to-face visits and monitoring by community services, and reduction of contact to telephone only, led to requests for MHA assessments which would not otherwise have been made and which did not warrant consideration of detention in hospital. During the lockdown many professionals moved to working from home, raising a number of issues in relation to support, supervision and management, particularly in the context of MHA assessment referrals, which by definition entail high risk with a need for rapid information gathering and assessment. Many respondents reported greater difficulty in accessing admission beds, possibly due to the need to isolate patients who were COVID-positive or at risk of being. Many areas found section 12 approved doctors less available, due to shielding, isolation or redeployment to COVID duties. Some ambulance services reduced or stopped providing transportation for mental health patients, leading to some services starting or increasing their use of private ambulance services.

Last updated on hub: 22 December 2020

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