Producing ‘Top Tips’ for Care Home Staff During the COVID-19 Pandemic in England: Rapid Reviews Inform Evidence-Based Practice but Reveal Major Gaps

Abstract

Background In many countries, care homes are being disproportionately affected by the COVID-19 global pandemic, with high rates of mortality (Oliver, 2020a; Comas-Herrera & Zalakin, 2020; British Geriatrics Society, 2020a). In the UK, central government guidance on how care homes should respond to COVID-19 has been inconsistent and criticised for being overly health-focused, disregarding the health and safety of the social care workforce and the conditions within which they are working (The National Care Forum, 2020). There are approximately 1.49 million people working in adult social (long-term) care in England, most of whom are employed by the independent sector (Skills for Care, 2019). Whilst demand for care has led to significant increases in the number of jobs in the social care sector, most of these (76%) are direct care roles, fulfilled by a workforce historically referred to as 'unskilled' (Skills for Care, 2019). Regulated professionals (e.g. social workers, occupational therapists and nurses) account for only 5% of the workforce, compared with 54% of the workforce in health (NHS Digital, 2018). Within adult social care in England, care homes account for approximately 42% of jobs (Skills for Care, 2019), caring for approximately 400,000 people (LaingBuisson, 2018), many of whom have multiple and complex needs, including need for nursing care (Gordon et al., 2014). Despite increases in the number of care jobs in nursing homes between 2009 and 2018, the number of registered nursing jobs has seen a significant decrease (down 20% since 2012). Due to population ageing and funding restrictions, older people living in care homes typically depend on staff to meet basic needs in the last year(s) of life (

A qualitative study of bereaved relatives’ end of life experiences during the COVID-19 pandemic

“…However, these necessitated facilitation by health and social care professionals and it appeared from this study that these virtual interactions were rare; this may reflect a lack of devices or available signal in the hospital or care home. 13 Other explanations may reflect the reliance on health and social care professionals who may have lacked adequate time to provide these aspects of supportive care, 14 or underestimated the importance of this communication for relatives when a family member is at end of life. 15 , 16 Being provided with the opportunity to connect with a dying family member in the final weeks and days of life may facilitate a better adjustment for relatives in their bereavement.…”

The Impact of Pandemic Management Strategies on Staff Mental Health, Work Behaviours, and Resident Care in One Long-Term Care Facility in British Columbia: A Mixed Method Study

“…Among these factors, we recommend a collaborative approach that actively seeks to integrate the voices and experiences of LTRC leaders, staff, residents, and families into policies and decisions. Collaboration is essential not only for effective implementation of the strategies, but also for communication during implementation (Browne et al, 2021;Towers et al, 2020). Without collaborative efforts, policies and management practices are likely to have unintended negative consequences.…”

Abuse and Wellbeing of Long-Term Care Workers in the COVID-19 Era: Evidence from the UK

“…As a result, COVID-19 rapidly spread in care settings, leading to a significant rise in deaths and excess mortality, especially in care homes [4]. Meanwhile, the Government's response was perceived as slow and indecisive [5], managers had to keep up with continuously changing guidance [6], and care workers had to take on tasks usually undertaken by registered nurses [7,8]. The increased volume of tasks during the pandemic resulted in higher workloads among existing staff [9].…”