“It's about how much we can do, and not how little we can get away with”: Coronavirus-related legislative changes for social care in the United Kingdom

Vicary, Sarah; Stone, Kevin; McCusker, Pearse; Davidson, Gavin; Spencer-Lane, Tim

doi:10.1016/j.ijlp.2020.101601

Cited by 10 publications

(8 citation statements)

References 5 publications

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“…Decision-making in many instances may have adopted a utilitarian rather than rights-based approach; this may have placed people with communication disabilities at an even greater risk of experiencing reduced access to healthcare, including rehabilitation, and inferior health outcomes (Kong, 2021). We agree with other commentators (Ruck Keene, 2020; Stavert & McKay, 2020;Vicary et al, 2020) that a utilitarian approach to resource allocation has the potential to discriminate against those who may need support to make decisions or may not be able to make or voice their own decisions. Healthcare decision-making should be based instead on a human rights-based approach that is consistent with UK mental capacity legislation.…”

Section: Discussionmentioning

confidence: 62%

Mental capacity legislation and communication disability: A cross‐sectional survey exploring the impact of the COVID‐19 pandemic on the provision of specialist decision‐making support by UK SLTs

Jayes

Borrett

Bose

2021

Intl J Lang & Comm Disor

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Background: Mental capacity legislation in the UK is designed to safeguard the rights of people who may need support, or may be unable, to make autonomous decisions. Very limited evidence has been published about the impact of the COVID-19 pandemic on the application of mental capacity legislation and, to our knowledge, none on the ability of speech and language therapists (SLTs) to support people with communication disabilities to engage in decision-making. Aims: To describe how UK SLTs supported people with communication disabilities to make decisions and participate in mental capacity assessments, best interests decision-making and advance care planning during the COVID-19 pandemic.Methods & Procedures: This descriptive, cross-sectional study used an online survey to collect quantitative and qualitative data about SLTs' practice experiences between August and November 2020. SLTs working with a range of adult clinical populations in different care settings were sampled purposively from all UK jurisdictions. Participants were recruited through professional networks and social media. Quantitative data were summarized using descriptive statistics. Qualitative data were analysed thematically.Outcomes & Results: Data were collected from 107 SLTs working in a range of settings across all four UK nations. The sample included SLTs working with people with neurological conditions, learning disabilities, mental health conditions and acute confusion. The need for SLT support appeared to increase during the pandemic. Most respondents were still able to offer support; however, the amount and nature of support varied. Quality of support was impacted by adjustments associated with social distancing and infection control restrictions. Personal protective equipment (PPE) was identified as a barrier to communication. Indirect working methods (e.g., telehealth) were inaccessible to some people with communication disabilities. Most respondents felt confident that legal requirements were upheld, but suggested this group was less able to engage in 172

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Section: Discussionmentioning

confidence: 62%

Mental capacity legislation and communication disability: A cross‐sectional survey exploring the impact of the COVID‐19 pandemic on the provision of specialist decision‐making support by UK SLTs

Jayes

Borrett

Bose

2021

Intl J Lang & Comm Disor

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“…Many services for older people, disabled people and carers provided by local authorities and third sector agencies disappeared overnight, while some agencies struggled under the increase in staff absences while staff self-isolated (Carers UK 2020a, b; Inclusion Scotland 2020). The Coronavirus Act 2020 amended social care legislation across the UK so that local authorities' duty to assess needs, provide social care services and support carers was relaxed to enable local authorities to focus on areas of most urgent need 8 as well as amending provision under mental health legislation (Vicary et al 2020). At the same time, a myriad of voluntary community and charitable organisations increased their services to provide food parcels, medication delivery services and social support, within strict limits.…”

Section: Adult Family Carersmentioning

confidence: 99%

Households, bubbles and hugging grandparents: Caring and lockdown rules during COVID-19

Gulland

2020

Fem Leg Stud

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Efforts to combat the COVID-19 crisis brought mountains of legislation and guidance to coerce or encourage people to stay at home and reduce the spread of the virus. During peak lockdown in the United Kingdom (UK) regulations defined when people could or could not leave their homes. Meanwhile guidance on social distancing advised people to stay within ‘households’. This paper explores the legislation under lockdowns in the UK from March to October 2020 and the implications for women’s gendered caring roles. The regulations and guidance assumed that households were separate units and ignored the interdependencies which exist between households and between individuals and wider society. The continuing focus in the lockdown regulations has been on households as autonomous, safe, adequate and secure. This overlooks the interdependency of human life, gendered aspects of caring and the inequalities of housing and living conditions, highlighted by feminist scholarship.

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“…In addition to the crisis of high COVID‐19 mortality, care home staff have, therefore, faced what Chu et al. ( 2020 ) refer to as a ‘competing crisis’: the deleterious physical and psychological effects of social isolation associated with severe restrictions (Amnesty International, 2020 ; Vicary et al., 2020 ).…”

Section: Introductionmentioning

confidence: 99%

COVID‐19 and the Mental Capacity Act in care homes: Perspectives from capacity professionals

Kuylen

Wyllie

Bhatt

et al. 2022

Health Social Care Comm

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This study explores the experiences of professionals who worked with care home residents with impaired mental capacity in England and Wales during the COVID‐19 pandemic. It explores (i) how competing risks were balanced and (ii) how the Mental Capacity Act (MCA) functioned in care homes under pandemic conditions, with particular focus on its associated Deprivations of Liberty Safeguards (DoLS) and Independent Mental Capacity Advocacy (IMCA) systems. Between March and May 2021, we held an online survey and five focus groups aimed at professionals who worked in or with care homes during the pandemic. The study explored issues pertaining to residents with impaired mental capacity, alongside several other topics on which we report elsewhere. For this paper, we filtered data to only include responses from ‘capacity professionals’. The resulting sample comprised 120 (out of 266) survey participants and 18 (out of 22) focus group participants. We performed manifest content analysis on the filtered data and found that (1) participants reported a ‘massive discrepancy’ between the ways different care homes balanced the risk of COVID‐19 infection with the risks associated with severe restrictions. (2) Some suggested this was due to vague guidance, as well as care home type and size. Participants told us the pandemic (3) obstructed smooth operation of statutory safeguards designed to protect residents’ human rights and (4) resulted in confusion about the remit of the MCA during a public health crisis. Our findings raise concerns about the impact of pandemic‐related measures upon care home residents with impaired mental capacity. We urge further exploration and analysis of (a) the variability and inconsistency of restrictions applied at care homes, (b) the strain placed on key safeguards associated with the MCA, (c) uncertainty about the remit of the MCA during a public health crisis and (d) the human rights implications hereof.

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“It's about how much we can do, and not how little we can get away with”: Coronavirus-related legislative changes for social care in the United Kingdom

Cited by 10 publications

References 5 publications

Mental capacity legislation and communication disability: A cross‐sectional survey exploring the impact of the COVID‐19 pandemic on the provision of specialist decision‐making support by UK SLTs

Mental capacity legislation and communication disability: A cross‐sectional survey exploring the impact of the COVID‐19 pandemic on the provision of specialist decision‐making support by UK SLTs

Households, bubbles and hugging grandparents: Caring and lockdown rules during COVID-19

COVID‐19 and the Mental Capacity Act in care homes: Perspectives from capacity professionals

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