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Fitzpatrick JM, Rafferty AM, Hussein S, et al. Challenges and guidance for implementing social distancing for COVID-19 in care homes: a mixed methods rapid review. Southampton (UK): National Institute for Health and Care Research; 2024 Nov. (Health and Social Care Delivery Research, No. 12.45.)
Challenges and guidance for implementing social distancing for COVID-19 in care homes: a mixed methods rapid review.
Show detailsCare home 1 | Care home 2 | Care home 3 | Care home 4 | Care home 5 | Care home 6 | |
---|---|---|---|---|---|---|
Date of data collection | 22 March 2021 | 13 April 2021 | 7 July 2021 | 21 February 22 | 27 September 2021 | 9 December 2021 |
CH data | ||||||
Location of CH | Midlands | Southeast England | Midlands | North England | London | London |
CQC rating of home | Good | Outstanding | Outstanding | Good | Good | Good |
CQC registration type | Dual registration | With nursing | With nursing | With nursing | Without nursing | Without nursing |
Type of service provided | Adults over 65 years, Adults under 65 years, Dementia, Physical disabilities | Adults over 65 years | Adults over 65 years, Adults under 65 years, Dementia, Learning disabilities, Mental health conditions, Physical disabilities, Neurorehabilitation | Adults over 65 years, Adults under 65 years, Dementia, Physical disabilities | Adults over 65 years, Dementia, | Adults over 65 years, Dementia, Learning disabilities, Mental health conditions |
Funding sources | LA, NHS and CCG, Self-funders, Combination | Self-funders | LA, NHS and CCG, Self-funders | LA, NHS and CCG, Self-funders | LA, Self-funders | LA, Self-funders, Combination (LA funding with client contribution) |
Number of beds offered in home | 64 | 37 | 45 | 73 | 64 | 48 |
Average bed occupancy | January 2020: 64 February 2020: 64 March 2020: 63 April 2020: 64 May 2020: 61 June 2020: 64 July 2020: 63 August 2020: 63 September 2020: 63 October 2020: 61 November 2020: 61 December 2020: 60 January 2021: 63 February 2021: 62 | January 2020: 26 February 2020: 26 March 2020: 27 April 2020: 30 May 2020: 30 June 2020: 29 July 2020: 26 August 2020: 26 September 2020: 26 October 2020: 26 November 2020: 26 December 2020: 26 January 2021: 26 February 2021: 25 | January 2020: 44 February 2020: 44 March 2020:44 April 2020: 44 May 2020: 44 June 2020: 44 July 2020: 44 August 2020: 44 September 2020: 44 October 2020: 44 November 2020: 44 December 2020: 44 January 2021: 44 February 2021: 45 | January 2020: 71 February 2020: 71 March 2020: 71 April 2020: 63 May 2020: 59 June 2020: 62 July 2020: 62 August 2020: 63 September 2020: 64 October 2020: 63 November 2020: 62 December 2020: 65 January 2021: 69 February 2021: 71 | January 2020: 98% February 2020: 99% March 2020: 94% April 2020: 75% May 2020: 67% June 2020: 90% July 2020: 91% August 2020: 87% September 2020: 89% October 2020: 88% November 2020: 88% December 2020: 88% January 2021: 89% February 2021: 90% | January 2020: 48 February 2020: 48 March 2020:48 April 2020: 48 May 2020: 46 June 2020: 46 July 2020: 46 August 2020: 48 September 2020: 46 October 2020: 45 November 2020: 45 December 2020: 48 January 2021: 48 February 2021: 48 |
Impact of COVID-19 on average bed occupancy | Data not provided | Closed one floor to be able to isolate floors and staff if had outbreak, so only had 26 rooms available from July 2020. | Zero impact. Although the number of beds offered is 45, this has been since January 2021, prior to that it was 44. | Significant reduction in occupancy over a period of a month during the first outbreak. This then took almost 12 months to fully recover. | Due to the impact of COVID-19, 16 beds were made unavailable from June 2020. From that period, the percentage is occupancy based on the number of beds available rather than number of registered beds. | No severe impact on bed vacancies. They have always stayed at a high level. |
Number of positive COVID-19 cases since March 2020 | March 2020: 0 April 2020: 18 May 2020: 10 June 2020: 2 July 2020: 2 August 2020: 0 September 2020: 0 October 2020: 9 November 2020: 27 December 2020: 22 January 2021: 24 February 2021: 12 | March 2020: 2 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021: 0 | March 2020: 0 April 2020: 1 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021: 0 | March 2020: 0 April 2020: 4 May 2020: 3 June 2020: 7 July 2020: 0 August 2020: 0 September 2020: 1 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 1 February 2021: 5 | March 2020: 11 April 2020: 4 May 2020: 1 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 1 February 2021:0 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 1 September 2020: 0 October 2020: 2 November 2020: 0 December 2020: 0 January 2021: 1 February 2021:0 |
Number of residents dying within 28 days of a first positive COVID-19 test (between 1 March 20 and 1 March 21) | Deaths in care home: 2 Deaths in hospital: 0 Deaths in another care home: 0 Death in other place: 0 | Deaths in care home: 0 Deaths in hospital: 0 Deaths in another care home: 0 Death in other place: 0 | Deaths in care home: 1 Deaths in hospital: 0 Deaths in another care home: 0 Death in other place: 0 | Deaths in care home: 4 Deaths in hospital: 0 Deaths in another care home: 0 Death in other place: 0 | Deaths in care home: 5 Deaths in hospital: 5 Deaths in another care home: 0 Death in other place: 0 | Deaths in care home: 0 Deaths in hospital: 1 Deaths in another care home: 0 Death in other place: 0 |
Did CH procure and carry out private testing for residents? | Yes – residents receive PCR tests every 4 weeks. | No | No | No | No | No |
Date testing commenced following government guidance | 8 June 2020 | 9 June 2020 | 1 September 2020 | 1 June 2020 | 18 May 2020 | 6 July 2020 |
Number of residents admitted to hospital with or suspected of having COVID-19. | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021: 0 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 9 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 1 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 |
Number of residents transferred to the CH from hospital and/or the community with COVID-19. | March 2020: 0 April 2020: 18 May 2020: 10 June 2020: 1 July 2020: 2 August 2020: 0 September 2020: 0 October 2020: 9 November 2020: 27 December 2020: 22 January 2021: 24 February 2021: 12 | March 2020: 1 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 0 April 2020: 1 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | Data not provided | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 0 February 2021:0 |
Since March 2020 have any residents been taken from the CH by family because of COVID-19? | No | No | No | Yes, 1 | Data not provided | No |
Start date of vaccination programme for residents | 16 January 2021 | 31 December 2020 | 1 January 2021 | 31 March 2020 | Data not provided | 5 December 2020 |
Are all residents vaccinated? | No – 1 resident refused the vaccine on several occasions. Two residents are not currently able to have the vaccine due to previously testing positive for COVID-19. | Yes – Fully vaccinated (second jabs, March 2021) | No – 44 residents are vaccinated, only one who is not and that is because they are clinically exempt due to severe allergies. | Yes | No | Yes – all fully vaccinated including boosters |
Monthly staffing vacancy rates in February 2020 (pre-COVID-19) – registered manager | 0% | 0% | 0% | CH provided this data in an unorthodox way which could not be used. | CH provided this data in an unorthodox way which could not be used. | 0% |
Monthly staffing vacancy rates in February 2020 (pre-COVID-19) – care worker | 0% | HCAs 4 × 36 hours | 5% | CH provided this data in an unorthodox way which could not be used. | CH provided this data in an unorthodox way which could not be used. | 0% |
Monthly staffing vacancy rates in February 2020 (pre-COVID-19) – senior care workers | 0% | 0% | 0% | CH provided this data in an unorthodox way which could not be used. | CH provided this data in an unorthodox way which could not be used. | 0% |
Monthly staffing vacancy rates in February 2020 (pre COVID-19) – RN | 1 × 44 hours night nurse vacancy | 0% | 0% | CH provided this data in an unorthodox way which could not be used. | CH provided this data in an unorthodox way which could not be used. | N/A |
Monthly staffing vacancy rates between March 2020 and January 2021 (during COVID-19) – registered manager | 0% | 0% | 0% | CH provided this data in an unorthodox way, which could not be used. | Data not provided | 0% |
Monthly staffing vacancy rates between March 2020 and January 2021 (during COVID-19) – care worker | 0% | HCA 36 hours | 10% | CH provided this data in an unorthodox way, which could not be used. | Data not provided | 2 posts (70 hours) |
Monthly staffing vacancy rates between March 2020 and January 2021 (during COVID-19) – senior care worker | 0% | 0% | 0% | CH provided this data in an unorthodox way which could not be used. | Data not provided | 0% |
Monthly staffing vacancy rates between March 2020 and January 2021 (during COVID-19) – RN | 1 × 44 hours night nurse vacancy | 0% | 10% | CH provided this data in an unorthodox way, which could not be used. | Data not provided | N/A |
Has the CH taken measures to avoid front-line staff moving between CHs? | Yes – staff are currently working solely at this CH. | Yes – stopped staff going to other CHs in the organisation. If they worked between two or more, they went to the home with the greater need. | Yes – staff only work at this CH. | Yes – the teams have not moved between villages as they normally would have done pre-COVID. Where possible, the teams have been allocated to individual households and encouraged to minimise the movement between households. | Yes – managed through effective resource planning, overtime and utilising bank colleagues | Yes |
Have front-line agency staff been employed during the COVID-19 pandemic since March 2020? | No | No | Yes – during the pandemic, used one Night Healthcare Assistant from an agency. This assistant only worked at this home. | Yes – single agency and block booking of staff to try and ensure familiarity and minimise the risk of contamination. | Data not provided | Yes – Two agency staff members (same staff that only worked within this CH, not agency staff who worked in multiple CHs) |
Did any front-line staff move into the home during the pandemic? | No, however there was a contingency plan in place if required. | No | Yes – Deputy Manager stayed at the home during her block of shifts. This was to protect the residents and her elderly parents who she lives with. This was a great support to the manager, as she helped with on-call duties overnight and at the weekend. | Yes – one member of night staff moved in for a period during the height of the pandemic. | No | No |
Have any front-line staff been off work due to having COVID-19 symptoms? | March 2020: 4 April 2020: 9 May 2020: 2 June 2020: 0 July 2020: 0 August 2020: 1 September 2020: 2 October 2020: 2 November 2020: 1 December 2020: 0 January 2021: 0 February 2021: 1 | March 2020: 2 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 2 January 2021: 1 February 2021:2 | March 2020: 0 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 1 October 2020: 0 November 2020: 0 December 2020: 1 January 2021: 1 February 2021:0 | March 2020: 10 April 2020: 16 May 2020: 6 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 3 October 2020: 6 November 2020: 3 December 2020: 8 January 2021: 6 February 2021:2 | March 2020: 10 April 2020: 2 May 2020: 0 June 2020: 0 July 2020: 1 August 2020: 1 September 2020: 2 October 2020: 2 November 2020: 1 December 2020: 2 January 2021: 1 February 2021:1 | March 2020: 0 April 2020: 2 May 2020: 2 June 2020: 2 July 2020: 1 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 1 January 2021: 0 February 2021:0 |
Have any front-line staff been off work due to the need to self-isolate because of family/others having COVID-19 symptoms? | March 2020: 3 April 2020: 2 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 1 February 2021: 0 | March 2020: 2 April 2020: 0 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 2 January 2021: 2 February 2021:0 | March 2020: 2 April 2020: 1 May 2020: 1 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 0 October 2020: 0 November 2020: 0 December 2020: 0 January 2021: 1 February 2021:1 | March 2020: 5 April 2020: 7 May 2020: 1 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 13 October 2020: 17 November 2020: 4 December 2020: 3 January 2021: 3 February 2021:0 | March 2020: 14 April 2020: 1 May 2020: 0 June 2020: 0 July 2020: 0 August 2020: 0 September 2020: 1 October 2020: 0 November 2020: 1 December 2020: 0 January 2021: 0 February 2021:0 | March 2020: 1 April 2020: 3 May 2020: 5 June 2020: 0 July 2020: 0 August 2020: 2 September 2020: 0 October 2020: 2 November 2020: 0 December 2020: 1 January 2021: 0 February 2021:0 |
Did the CH procure and carry out private testing for staff? | Yes – staff have their PCR tests every week and have LFTs twice a week | Yes – antibody testing | No | No | No | No |
When did lateral flow testing for staff commence? | 4 January 2021 | 1 December 2020 | 1 September 2021 | 13 August 2020 | 23 December 2020 | December 2020 |
When did the vaccine programme for staff start? | Some staff travelled to a hospital for their vaccine and the first appointment was on 17 December 2020. The majority of staff were vaccinated at the home on 16 January 2021 | 31 December 2020 | 1 January 2021 | 11 March 2021 | Data not provided | 5 December 2020 |
What percentage of CH staff have been vaccinated? | 85% of staff have received first vaccine. Out of the remaining staff, three have been booked in to have their vaccine, three staff cannot have the vaccine, three staff are on maternity leave and the remaining two staff have declined. | 98% | 98% plus three staff clinically exempt | 100% | 88% | 100% |
How has testing of visitors to the CH been managed? | At the moment, we are open to essential appointments and booked visits for the residents (visitors are from the nominated persons list). All visits are pre-arranged, and visitors are informed that they are to arrive half an hour before their scheduled time and report to a member of staff. At this point, we then ask them to complete the necessary paperwork and an LFT test then they are to await the results. As long as the result is negative, the visit can continue. With regard to professional visiting, if the visitors are from an organisation that complete LFT testing at home, they must show proof of a negative test that has been completed within the last 72 hours; if they are unable to provide this evidence, then they are to follow the guidance for completing the LFT testing within the home. | Data not provided | This has involved a lot of time with weekly PCR testing for all staff, twice weekly LFT testing for all staff, four weekly PCR testing for residents. Once visiting opened up again, all visitors are required to have a LFT, they then have to wait for 30 minutes and if the result is negative, they are then able to visit. Any professionals visiting the home also have to either have a negative LFT that is taken here or need to provide a negative result taken no longer than 30 minutes prior to coming to the home. Our hairdresser has been back for 8 weeks now, she takes part in the staff weekly PCR testing and has to have an LFT, again with a negative result, prior to starting work on the day she comes. The registration of all tests is very time consuming, with the website regularly crashing, and this can take several hours per day. Then starts the anxiety of waiting for the PCR results to come through. | Testing station set up in the village for testing to be carried out on all visitors. Relatives were asked to attend 30 minutes before a scheduled visit so that a LFT could be carried out by a member of staff. Records of the test were kept for 21 days before being destroyed. | Data not provided | Data not provided |
Organisational data | ||||||
Number of CHs in the organisation | 63 | 21 | 13 | 7 | 114 | 7 |
Number of beds offered across the organisation | 4911 | 1163 | 767 | 500 | 5875 | 304 |
Location(s) of homes across the country | Midlands | South England | South England | North England | North England Midlands South England | South England |
Ownership of organisation | Private organisation | Private family run | Private organisation | Voluntary/not for profit | Voluntary/not for profit | Private family run |
- A summary of the routinely collected care home data by case study site - Challen...A summary of the routinely collected care home data by case study site - Challenges and guidance for implementing social distancing for COVID-19 in care homes: a mixed methods rapid review
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