ENRICHEnabling Research in Care Homes
Do you work in a care home?
Researcher at Glasgow Caledonian University are researching the impact of COVID 19 on staff working in nursing and residential care homes across the UK and Ireland. We know the pandemic continues to present many difficulties for people who live and work in the care home sector and we believe it is important to hear the voices of the people at the frontline.
We are inviting you to tell us about your experiences by completing an anonymous online questionnaire.
If you work in any role, in one or more care homes, please help us to learn more about your experiences with COVID 19.
If you would like more information about this study Information about the research please click here
If you would like to complete the survey it can be found here
“This report aims to provide an overview of data and policies in relation to COVID-19 vaccinations for people who use and provide long-term care. It is a “living report” that will be updated regularly, please email email@example.com if you would like to contribute or aware of relevant sources of information.
- The report shows data for populations that either use and provide long-term care or are likely to do so. So far very few countries routinely share data on the characteristics of people who are receiving vaccinations. In all other countries the data has been announced by official sources to the media.
- On the 11th January we have found data on COVID-19 vaccinations in care homes for 8 countries, and for some regions/nations in Spain and the United Kingdom.
- 2 countries (Denmark and Israel) and a region in Spain (Asturias) report having completed first doses of vaccination for all care home residents and staff. Over half of all care home residents are reported to have been given a first dose of vaccine in Catalonia (Spain), Northern Ireland and Scotland, and over a quarter in Croatia, Cyprus and Germany, and close to 15% in Italy and the United States.
- The share of doses of vaccines given to people living in care homes ranges from 6% in Italy to 73% in Croatia.
- We have not found official data, so far, on the share of care home residents who either refuse the vaccination, cannot consent or are excluded from vaccination due to other reasons.
- Initial review of prioritization documents shows that all countries prioritise vaccinations for healthcare staff, and, with slight variations in order, care home residents and staff, older people and, less frequently, people who rely on care in the community and unpaid carers.
- Indonesia is an exception in that the working age population is currently prioritised and not older people.
- There are few mentions of people living with dementia or people with learning disabilities.”
The full report is available here
Authors: Shoshana Lauter, Klara Lorenz-Dant, Adelina Comas-Herrera (Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science) and Eleonora Perobelli (Observatory on Long-Term Care, CERGAS SDA Bocconi)
“The COVID-19 crisis has brought with it many challenges, but few have been as striking as those facing care homes. Working in collaboration with the Royal College of General Practitioners, THIS Institute is seeking to appoint a fellow to lead a study aimed at co-producing a vision for high quality primary care for people who live in care homes and a theory of change for how it might be achieved within current structures and resources.
The successful applicant will remain employed by their own university or organisation, and will be part of a vibrant professional learning community supported by THIS Institute. The fellowship should be completed in 12-15 months, and can be undertaken full-time or part-time (minimum 0.6 FTE). It is expected that the fellowship will begin during Spring 2021.”
Application deadline 22 January 2021
To find out more about this opportunity click here
Coping with infection-control measures in Care Homes during the COVID-19 pandemic
“We are a group of researchers from the University of East Anglia (Norfolk, UK) and we are looking for care home staff to take part in a short survey to tell us what it has been like to cope with trying to prevent the spread of infection in care homes during the COVID-19 pandemic.
The survey takes approximately 10 minutes to complete, and if you leave your contact details, we will enter your name into a prize draw for the chance to win one of five £10 Amazon gift vouchers.
To complete the survey, please click on this link.
We would also like to interview some care home staff by telephone or online. Online platforms may be Zoom, Microsoft Teams or WhatsApp, but others may be available. The choice will depend on what you prefer and whether the researcher has access to the same technology. If you are interested in this part please contact Dr Julii Brainard (firstname.lastname@example.org Dr Diane Bunn (email@example.com) at the University of East Anglia for further information.”
This study is funded by the NIHR Health Protection Research Unit in Emergency Preparedness at the University of East Anglia.
Hannah Flack, Communications Administrator for THIS Institute (The Healthcare Improvement Studies Institute) at University of Cambridge, would like to draw your attention to a fellowship opportunity.
The Healthcare Improvement Studies Institute (THIS Institute) is launching a new fellowship to coproduce a vision for high quality primary care for people who live in care homes, and to identify how it might be implemented and achieved within current resources and structures.
The fellowship is suitable for applicants who are currently in post at UK universities or other research intensive environments. Applicants should be experienced and skilled qualitative researchers who can lead the project independently while sustaining excellent relationships with collaborators, patients and families, clinicians, and wider health service stakeholders.”
Deadline for applications is midday, 22 January 2021
To find out more click here
The LTCcovid attempt to present comparable data and statistics on the effect of COVID-19 within long-term care (LTC) settings in the UK, with a particular focus on care homes.
‘The impact of the COVID-19 pandemic on the oldest old, especially those within care home settings, has been devastating in many countries. The UK was no exception. This article reviews the path of the COVID-19 pandemic across the UK long-term care (LTC) sector, indicating how it evolved in each of the four home nations. It prefaces this with a description of LTC across the UK, its history and the difficulties encountered in establishing a satisfactory policy for the care of frail older people across the home nations.’
The paper makes several contributions:
- First, it provides an up to date estimate of the size of the adult care home sector across the UK – previous work has been bedevilled by inaccurate estimates of the number of care home places available.
- It assembles the limited information that is available on delayed transfers of care and testing of care home residents, both of which played a role in the evolution and consequences of the pandemic.
- It estimates the number and share (the P-Score) of “excess deaths” in care homes in each of the home nations. The P-Scores provide measures that allow comparisons across care home populations of different size.
‘Not only do we discuss the number of individuals affected, we also compare the proportions of care homes in each of the home nations that experienced a COVID-19 infection. The paper also discusses deaths of care home residents outside care homes, largely in hospitals. It reviews the sparse information on deaths at home of people who were receiving social care.’
For access to the full report click here
The University College London has published a new guide for family and/or friends caring for a person living with dementia to support decision-making during COVID-19 and beyond:
‘We are an experienced team of researchers and health and social care professionals including GPs and Psychiatrists from University College London and King’s College London, and a group of people living with dementia and family carers. We have used the latest evidence from research and clinical practice, together with the views and experiences of people with dementia and family carers. We have received expert input and this document has been reviewed by GPs, palliative medicine doctors, nurses, geriatricians, psychiatrists, and social care professionals. This project has been supported by Marie Curie, Alzheimer’s Society, Dementia UK, and Royal College of Nursing who have all contributed to the development and reviewed this document.’
To access the guide please click here
“In May and June of 2020, a survey of the QNI’s Care Home Nurses Network was carried out by the QNI International Community Nursing Observatory (ICNO) to understand more about the impact of Covid-19 on the Care Home Nurse workforce within the UK. This survey was launched in the early weeks of the pandemic in response to grave concerns about the safety of the workforce and the gaps in provision that it was facing. The survey responses confirm that for the majority of respondents, the pandemic has been a very challenging experience. They indicated that their work and wellbeing has been worse or much worse than at normal times, during the survey period.
Having to accept patients from hospitals with unknown Covid-19 status, being told about plans not to resuscitate residents without consulting families, residents or care home staff, lack of guidance on issues like personal protection and issues of poor access to pay if they became ill were some of the major issues the care home workforce faced during March and April 2020.
While two thirds of respondents said they ‘always’ had access to appropriate personal protective equipment (PPE) and most others said that it was usually available, a small minority were not provided with PPE and had to improvise, by obtaining it themselves or by making it. The need for appropriate PPE in care homes is of critical importance in staff and resident safety: 21% of respondents said that their home accepted people discharged from hospital who had tested positive for Covid-19.
The majority of survey respondents found it easy to access hospital care for their residents when this was required; however, a substantial minority found this difficult or very difficult. Additionally, a substantial number found it difficult to access District Nursing and GP services, which are universal parts of the National Health Service. In addition, many indicated that they were not able to access essential training from other health professionals at this time.
Some respondents refocused work to consider how they could improve on their approach to end of life care. Worryingly, some who responded raised serious ethical and professional concerns, for example GPs, Clinical Commissioning Groups and hospital trusts making resuscitation decisions without first speaking to residents, families and care home staff or trying to enact ‘blanket’ ‘do not resuscitate’ decisions for whole groups of people.”
Dr Crystal Oldman CBE, the QNI’s Chief Executive commented:
“The care being delivered in a home can at times be as intensive as in a hospital – in particular for end of life care – and it is hugely skilled work. As the majority of respondents to this survey indicate, the people living in their care homes need a combination of support for complex physical and cognitive needs.
“Overall, as would be expected, the picture presented is of an extremely stressful and anxious period for professionals working to care for and protect their residents. The positives represent a silver lining to this cloud and there are numerous testaments to the skill, dedication, professionalism and teamwork that Care Home Nurses have displayed in 2020. In addition, this brief insight into the experiences of the nurses provides an opportunity to consider and plan for the support systems that may be needed in the anticipated second wave of Covid-19.
“More needs to be done to understand the effect of Covid-19 on the workforce and residents in care homes. Urgent attention must be paid to the sector if the workforce is to withstand the additional demands of the pandemic, particularly in planning, guidance and employment practices.”
For access to the full report click here
If you have used a phone, tablet or laptop to ‘visit’ a friend or relative in a UK care home or hospital during COVID-19 and would be interested in advising on a new project that will explore the impact of visiting in this way please contact Laura.Goodwin@uwe.ac.uk
The NIHR supported Vivaldi care home study have published findings from a large scale survey which examined COVID-19 infections in care homes for those aged over 65 in England.
“The results are based on analysis of the survey responses from 5,126 out of 9,081 care homes in which care home staff were asked to report on the total number of confirmed cases among staff and residents since the start of the pandemic.
The weighted period prevalence1 of infection in:
- residents was 10.5% (95% confidence interval: 9.9% to 11.1%)
- staff was 3.8% (95% confidence interval: 3.4 to 4.2%)
Based on analysis of test results from the Whole Care Home Testing Programme (of all 9,081 homes tested via pillar 2 between 11 May and 7 June):2
- 2.4% of all tests were positive (9,674 out of 397,197)
- 3.9% of residents tested positive (6,747 out of 172,066)
- 3.3% of asymptomatic residents tested positive (5,455 out of 163,945)
- 80.9% of residents who tested positive were asymptomatic (5,455 out of 6,747)
- 1.2% of asymptomatic staff tested positive (2,567 out of 210,620)
The survey provided data on denominators (staff and residents) as well as estimates of infections, mortality, and risk factors for infection since the start of the pandemic, to provide figures for prevalence.”
The study found:
- Regular use of ‘bank’ staff is an important risk factor for infection in residents and staff.
- Infections in staff are a risk factor for infection in residents and infections in residents are a risk factor for infection in staff. However, the magnitude of this effect suggests staff are more likely to transmit infections to residents than vice versa.
- Emerging data suggests that the number of new admissions, and return of residents to the care home from hospital, may be important risk factors for infection in residents and staff. This has only been tested in unadjusted analysis due to a high proportion of missing data across these variables.
- Region is an important risk factor for infection in staff and residents, but its effect is different in staff and residents. This may be due to temporal differences in the timing of testing between staff and residents.
This project is funded by the DHSC