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News Article
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 -
News Article
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 -
News Article
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 -
Content ArticleThis article from Petriceks and Schwartz, published in Palliative & Supportive Care, describes a four-element approach centered on Goals, Options, Opinions and Documentation that serves as an effective structure for clinicians to have conversations with patients and families to address care management when the path forward is unclear.
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Content ArticleThe Care Quality Commission (CQC) has published the first of what will be a regular series of insight documents intended to highlight COVID-19 related pressures on the sectors that CQC regulates. This document draws on information gathered through direct feedback from staff and people receiving care, regular data collection from services who provide care for people in their own homes, and insight from providers and partners. The information collected from these sources is being used to understand the wider impact of COVID-19, to share regular updates with local, regional, and national system partners and the Department of Health and Social Care, and to highlight any emerging trends and issues. This 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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Content ArticleIn this briefing The Health Foundation provides an overview of the impact of the COVID-19 pandemic on social care in England. In part 1 they describe how the pandemic unfolded in the social care sector from March until June 2020, and in part 2 they examine the factors that contributed to the scale and severity of outbreaks in care homes. In part 3 they attempt to quantify the disruption to health and social care access from February until the end of April 2020. Key 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 ArticleVenous thromboembolism (VTE) is a condition in which a thrombus – a blood clot – forms in a vein. Usually, this occurs in the deep veins of the legs and pelvis and is known as deep vein thrombosis (DVT). The thrombus or its part can break off, travel in the blood system and eventually block an artery in the lung. This is known as a pulmonary embolism (PE). VTE is a collective term for both DVT and PE. With an estimated incidence rate of 1-2 per 1,000 of the population, VTE is a significant cause of mortality and disability in England with thousands of deaths directly attributed to it each year. One in twenty people will have VTE during their lifetime and more than half of those events are associated with prior hospitalisation. At least two thirds of cases of hospital-associated thrombosis are preventable through VTE risk assessment and the administration of appropriate thromboprophylaxis. These 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 ArticleADASS, is a charity that provides a national voice and leadership for adult social care. In 2019, they published a report, Sort out social care, for all, once and for all, setting out what they believe needs to be done by the Government to tackle the crisis. The report called for: Short-term funding, including continuation of the Better Care Fund and Improved Better Care Fund, to prevent the further breakdown of essential care and support over the course of the next financial year. Long-term funding and reform following, to enable us to build care and support for the millions who need it and create a social care system that is truly fit for the 21st century. A long-term plan for adult social care which means a support system in place that links with other public services including the NHS and supports resilient individuals, families and communities. This powerful info-graphic highlights 15 reasons why action is needed in adult social care:
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Content ArticleIn recent years, there has been an increasing focus on the role of safety culture in preventing incidents such as medication errors and falls. However, research and developments in safety culture has predominantly taken place in hospital settings, with relatively less attention given to establishing a safety culture in care homes. Despite safety culture being accepted as an important quality indicator across all health and social care settings, the understanding of culture within social care settings remains far less developed than within hospitals. It is therefore important that the existing evidence base is gathered and reviewed in order to understand safety culture in care homes. A scoping review was undertaken to describe the availability of evidence related to care homes’ patient safety culture, what these studies focused on, and identify any knowledge gaps within the existing literature. Included papers were each reviewed by two authors for eligibility and to draw out information relevant to the scoping review. Safety culture in care homes is a topic that has not been extensively researched. The review highlights a number of key gaps in the evidence base, which future research into safety culture in care home should attempt to address.
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Content ArticleIn this briefing, the Improvement Analytics Unit (a partnership between the Health Foundation and NHS England) identifies some early signals of changes in hospital use by vanguard care home residents in Wakefield, in order to inform local learning and improvement. Key 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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Content ArticleState of Care is the Care Quality Commission (CQC) annual assessment of health care and social care in England. The report looks at the trends, shares examples of good and outstanding care, and highlights where care needs to improve. Key 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.
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Content Article"It’s time to halt, take a break, and redraw the relationship between patient care and self-care. Self-care isn’t an optional luxury. It must sit at the heart of what we do, to ensure our teams can continue to rise to the challenges of working in the 21st century NHS, to give our patients the best of both ourselves, and the organisation so many of us are proud to be a part of." This editorial by Dr Michael Farquhar, published in Anaesthesia, explains the importance of taking breaks while on shift and ensuring a good sleep between shifts and the inextricable link between sleep and patient safety.
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Content ArticleThis report, from the International Long Term Care Policy Network, provides examples of the policy and practice measures that have been adopted internationally to prevent COVID-19 infections in care homes and to mitigate their impact. This is a 'live' document that will be updated regularly and expanded as more information becomes available.
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Content ArticleEmotional resilience has become a buzzword in the helping professions. Although resilience has been incorporated into the “official discourse” of social work, it is important to consider: • What does resilience mean? • To what extent do we as social workers need to be resilient? • Can resilience really protect our wellbeing and improve our professional practice? • Perhaps most importantly, how can we build our resilience to help us thrive in a profession that, although rewarding, can be very stressful? This evidence-based resource by Community Care Inform, aims to provide some guidance to help you navigate your professional journey. Based on their own research and that of others, they highlight the importance of emotional resilience in protecting your personal wellbeing and enhancing your professional practice and suggest ways to help you develop this important quality.
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Content ArticleThe impact of COVID-19 has created an extremely challenging time for the social care workforce. Skills for Care have identified training that remains a priority during this period to ensure there is a skilled and competent workforce. The training is available as three individual packages of learning, rapid induction programme (aimed at new staff), refresher training (aimed at existing staff) and a volunteer programme. Find out more on each area via the link below.
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Content Article
Carers UK: Coronavirus guidance
Patient Safety Learning posted an article in Good practice and useful resources
Carers UK's website sets out the current government guidance as it relates to carers and offers suggestions for making plans. They've also answered common questions many carers have been asking on their FAQ page and offer some tailored tips on keeping a positive frame of mind in their Wellbeing Action Plan. For recent updates to the benefits system, see their A-Z of changes to benefits, assessments and support – COVID-19. -
Content ArticleIn this blog, Patient Safety Learning considers the impact of the COVID-19 on the social care sector in the UK. This blog highlights the emerging patient safety issues the pandemic is creating in the sector and recommends some essential steps that need to be taken now to tackle some of the most urgent patient safety concerns. It 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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Content ArticleThis is the written transcript and the video recording of the Health and Social Care Committee meeting that took place on Friday 17 April on the topic of: Management of the Coronavirus Outbreak. Witness(es): Dr Alison Pittard, Dean, Faculty of Intensive Care Medicine; Dame Donna Kinnair, Chief Executive and General Secretary, Royal College of Nursing; Professor Anthony Costello, Professor, UCL Institute for Global Health Witness(es): Matt Hancock, Secretary of State, Department for Health and Social Care; Jonathan Van-Tam, Deputy Chief Medical Officer for England, Department for Health and Social Care
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Content ArticleBBC Radio 4's You and Yours programme discusses the impact of coronavirus on social care and asks listeners if they feel their relatives in care are being properly protected? One listener, Amanda, speaks about the recent loss of her father who had Alzheimer's Disease. Following a fall and a hospital admission, he contracted the virus. A second caller, Bill, talks about the challenges and risks associated with needing care and support at home as a disabled man. Follow the link below to hear the full programme. This feature aired on 14 April 2020.
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Content Article
Healthier Lancashire & Cumbria - Digital Future
Gary Saunders posted an article in Implementation of improvements
A case study on how Healthier Lancashire and Cumbria have been driving forward their digital strategy. This strategy includes how they are standardising and redesigning digital systems to improve patient safety (see Theme 4 - Manage the system more effectively). -
Content ArticleA collection of guides from Public Health England on how reasonable adjustments should be made to health services and adjustments to help people with learning disabilities to access services. Under 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 ArticleThe intention of this regulation, by the Care Quality Commission, is to prevent people from receiving unsafe care and treatment and prevent avoidable harm or risk of harm. Providers must assess the risks to people's health and safety during any care or treatment and make sure that staff have the qualifications, competence, skills and experience to keep people safe. The regulation does not apply to the person's accommodation if this is not provided as part of their care and treatment.
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Content ArticleThis is a summary of the Care Quality Commission (CQC) report into social care in the UK. This report is written to target all audiences. This 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 Article
Releasing Time to care, The NHS Productive Series (NHS Improvement)
Claire Cox posted an article in Environmental
The successful NHS Productives series, from NHS Improvement, are about ‘the how not the what’ and use a learning by doing approach that builds knowledge and skills to support frontline teams to make real and lasting improvements for themselves. This toolkit includes: The Productive Leader The Productive Ward The Productive Mental Health Ward The Productive Operating Theatre Productive Community Services The Productive Community Hospital Productive Endoscopy If you work in the NHS or social care you can access online (downloadable PDF) versions of the boxsets free of charge. To get your copy, email [email protected]. -
Content ArticleThis document by the Care Quality Commission (CQC) sets out what needs to be reported to the CQC if working within social care. Medication errors are not usually required to be reported to the CQC 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?
