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Content ArticleKey points: The coronavirus (COVID-19) pandemic has had a profound impact on people receiving and providing social care in England. Since March, there have been more than 30,500 deaths among care home residents than we would normally expect, and a further 4,500 excess deaths among people receiving care in their own homes (domiciliary care). There has been a greater proportional increase in deaths among domiciliary care users than in care homes (225% compared to 208%). And while deaths in care homes have now returned to average levels for this time of year, the latest data (up until 19 June) shows that there have continued to be excess deaths reported among domiciliary care users.Social care workers are among the occupational groups at highest risk of COVID-19 mortality, with care home workers and home carers accounting for the highest proportion (76%) of COVID-19 deaths within this group. During March and April, there was a substantial reduction in hospital admissions among care home residents. Elective admissions reduced to 58% of the 5-year historical average and emergency admissions to 85% of the 5-year historical average. By reducing admissions, care home and NHS teams may have reduced the risk of transmission, but there may have also been an increase in unmet health needs. During March and April, discharges from hospitals to residential care homes were 75% of the historical average, while discharges from hospitals to nursing homes increased to 120% of the historical average. These difficult decisions to discharge patients were made in an urgent and uncertain context but may have played a role in transferring risk to a poorly supported social care system.
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Content ArticleThis first insight document focuses on adult social care: reviewing data on outbreaks, deaths and availability of personal protective equipment (PPE), and in particular highlighting the impact of COVID-19 on staff wellbeing and the financial viability of adult social care services. It describes the need – now more acute than ever – for whole system working across different sectors to ensure safer care. It also outlines future areas of focus, including infection control both within and between services, how local systems are engaging social care organisations in the management of COVID-19, and how care for people from vulnerable groups is being managed through the crisis.
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Carers UK: Coronavirus guidance
Patient Safety Learning posted an article in Good practice and useful resources
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Content ArticleIt is no secret that social care was under immense pressure well before the spread of the COVID-19. Those involved in social care have been calling for the introduction of long-term reforms to ensure that it is fit for purpose, that care workers are invested in and that appropriate support is in place for unpaid carers. Going into the 2019 General Election, all parties recognised the need to reform the system and the Conservative Party was elected on a pledge to find a long-term solution for social care.[ As the impact of the pandemic now takes hold, the ability of the social care system to respond to these issues is beginning to come into focus. In this blog, we look at the emerging patient safety issues the pandemic is creating in the sector, focusing on four main areas: Staff safety and lack of access to appropriate personal protective equipment (PPE). The pandemic’s impact on existing social care and provision for non COVID-19 patients. The impact on carers and families of those receiving social care. The reporting of COVID-19 deaths outside of hospitals. In response to these issues, Patient Safety Learning have identified some essential steps that that can be taken at a national and local level to tackle some of the most urgent patient safety concerns: Staff safety PPE distribution to social care should be treated with the same urgency as it is for healthcare. Clear guidance should be provided on PPE requirements for specific social care roles. Clear guidance should be provided on what steps staff can take to report problems accessing PPE. Steps must be taken to ensure that there is enough staffing and volunteer capacity to enable staff to work safely. Patient safety All patients and social care service users should receive the care requirements outlined in their care packages. There should be clear guidance on what steps families and staff can take to report problems in service provision or to report safety concerns. Mitigating the impact on existing care and treatment The rollout of testing for COVID-19 in social care needs to increase as soon as possible to identify and isolate outbreaks. We need to work with care providers to support the continued provision of services and provide adequate staffing levels during this period. We must work with third sector organisations to help provide guidance and support for carers and families. We need to ensure that the extra funding committed to the healthcare system is also available to provide to social care.
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Coronavirus: Social care concerns revealed in leaked letter
Patient Safety Learning posted a news article in News
A leaked letter seen by the BBC has revealed an extensive list of concerns about how the social care sector is coping with the coronavirus crisis. The letter raises fears about funding, testing, personal protective equipment (PPE) and the shielding scheme for vulnerable people. Written on Saturday, to a senior official at the Department of Health and Social Care by the Association of Directors of Adult Social Services (Adass), it says mixed messages from the government have created "confusion and additional workload". On protective equipment for care workers, the letter says the national handling has been "shambolic". Early drops of equipment have been "paltry" and more recent deliveries have been "haphazard", with some even being confiscated by border control for the NHS. And while the rollout of testing for care workers has been generally welcomed, the letter states "testing for care workers appears to be being rolled out without being given thought to who is going to be tested and what we are going to do with the result". Read full story Source: BBC News, 16 April 2020 -
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Non-acute services to receive 30 million PPE products
Patient Safety Learning posted a news article in News
Adult social care services are to receive millions of personal protective equipment products following a national audit of personal protective equipment (PPE), HSJ can reveal. The government will deliver more than 30 million items to local resilience forums in the coming days, for distribution among social care and other front-line services, according to a letter seen by HSJ. The stock should not be sent to acute trusts or ambulance services, the letter, from health and social care secretary Matt Hancock and housing, communities and local government secretary Robert Jenrick, stated. Describing an “urgent need” for PPE in front-line services, Mr Hancock and Mr Jenrick asked local planners to distribute this latest batch of stock “only where there is a clear and pressing need”. Read full story Source: HSJ, 6 April 2020 -
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Covid-19: guidance on home care provision
PatientSafetyLearning Team posted an article in Guidance
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UK government must recognise care workers are on the coronavirus frontline too
Patient Safety Learning posted a news article in News
Social care has a vital part to play in the fight against Covid-19, but without proper support more lives will be put at risk, says Vic Rayner, Executive Director of the National Care Forum. "We are working round the clock to keep the people we care for safe and happy and to protect our staff. We know the COVID-19 situation is moving fast – but the care sector can only effectively play its part with more direct support from the government." Social care providers, like many across the country, are working hard to prepare for the escalation of COVID-19. This includes refresher training on infection control, robust measures to ensure any visitors to care services are safe to enter, planning for how to keep going in the face of significant workforce shortages, and ensuring the people they care for and their staff are kept safe and well. However, it is clear that social care is in urgent need of help, more directly and more quickly, to meet the needs of the most vulnerable, or to ensure that their staff are adequately protected. The issue of protection is never far from care providers’ minds, and the lack of personal protective equipment (PPE) for care staff remains a pressing problem. Read full story Source: The Guardian, 20 March 2020 -
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Learning from excellence: Entrance interview questionnaire
Claire Cox posted an article in Motivating staff
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Content ArticleThese are the recommendations following the review of current VTE standards in UK Care homes. 1.Further academic research should be conducted to clinically establish the extent to which care home residents in England are at an increased risk of preventable blood clots, and what the appropriate threshold for thromboprophylaxis should be. 2. The CQC should develop national guidance on prevention and management of VTE in the care home setting, closely informed by the latest academic research on the risk of VTE in care homes in England. 3. All hospitals should include a mandatory section on VTE risk in their discharge summaries, indicating instructions on the steps that should be taken to manage the patient’s risk. 4. CCGs should work with local secondary, primary and social care providers to develop local transfer of care protocols to facilitate smooth transfer of care between hospitals and care homes and clarify procedures for managing patients’ VTE risk post-discharge. 5. CCGs should develop community-based VTE treatment pathways for occurrences and recurrences of VTE in the care home setting to relieve capacity pressure on hospitals and ensure timely treatment.
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Content ArticleThis powerful info-graphic highlights 15 reasons why action is needed in adult social care:
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Content ArticleUnder the Equality Act 2010, public sector organisations must make changes in their approach or provision to ensure that services are accessible to disabled people as well as everybody else. This series of guidance shares information, ideas and good practice in making reasonable adjustments for people with learning disabilities in specific health service areas. It is aimed at health and social care professionals and family members who provide support for, or plan services used by, people with learning disabilities. There is also an easy-read summary for each service area.
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Content ArticleKey points: An evaluation of hospital use among 526 residents aged 65 or over living in 15 vanguard nursing or residential care homes in Wakefield between February 2016 and March 2017, compared with a local matched control group. The enhanced support they received had three main strands: voluntary sector engagement, a multidisciplinary team and enhanced primary care support. Estimations show that vanguard residents experienced 27% fewer potentially avoidable admissions than the matched control group – the effect was stronger among those who had been resident in a care home for three months or longer. But there was no conclusive evidence that overall emergency admissions or A&E attendances differed between the vanguard residents and those in the matched control group.
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Healthier Lancashire & Cumbria - Digital Future
Gary Saunders posted an article in Implementation of improvements
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Content ArticleMedication errors are not usually required to be reported to the CGC unless in these circumstances: death injury abuse, or allegation of abuse incident reported to or investigated by the police. Challenge: How do social care and non-NHS providers ensure that concerns are raised and there is a safe reporting culture?
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Content ArticleThis summary gives a basic overview on: Sustainable care Access to care and support Quality of care Workforce Capacity to meet demand Funding and commissioning Joined up care
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Content ArticleKey findings: Most of the care that we see across England is good quality and, overall, the quality is improving slightly. But people do not always have good experiences of care and they have told the CQC about the difficulties they face in trying to get care and support. Sometimes people don’t get the care they need until it’s too late and things have seriously worsened for them. This struggle to access care can affect anyone. Too many people find it hard to even get appointments, but the lack of access is especially worrying when it affects people who are less able to speak up for themselves – such as children and young people with mental health problems or people with a learning disability. Too often, people must chase around different care services even to access basic support. In the worst cases, people end up in crisis or with the wrong kind of care.
