Resource for day centres – Guide for adult day centres to ‘unlock lockdown’ safely

Caroline Green and Katharine Orellana, Post-Doctoral Fellows, National Institute for Health Research Applied Research Collaboration South London. (721 words)

On 23 March 2020, most of England’s population was placed into ‘lockdown’ due to the novel Coronavirus or COVID-19 pandemic taking hold across the UK. This was an unprecedented move by the government and meant that social care services, including day centres for older people or those with social care needs mostly closed to regular users.

Several months later, the government is taking a step-by-step approach to ‘unlocking’ society, with social clubs and community centres allowed to open again from 4 July 2020. But, with the pandemic not yet subsided, day centres are faced with the task of making their services safe and reducing the risks of infections to service users and staff. This is particularly important for day centres, as they may serve groups of people at risk of being seriously affected by the virus, such as people with underlying health conditions.

To date, day centres have not been issued with any guidance on how to go about unlocking their services safely and inviting users back. NIHR ARC South London has produced guidance that aims to support managers or volunteer co-ordinators of day centres to plan for a ‘new normal’. We are also working with the Social Care Institute for Excellence (SCIE) to help take this further.

The resource is free of charge, can be easily downloaded and printed off. We would really appreciate feedback on the document’s usefulness. Please follow this link to find the resource:

Helping adult day centres to ‘unlock lockdown

The guidance has two parts:

Part 1 covers some of the practicalities of re-opening. We draw on guidance related to Coronavirus or COVID-19, on other guidance related to social care (e.g. Department of Health and Social Care guidance on risk empowerment), and relevant guidance, advice, action points for regulated settings (such as early years day care and care homes), some of which is also relevant to adult day centres. The reader is prompted to think about the specifics of their own activities. As every setting is different, providers will need to use their professional judgement, and take account of public health guidance to maximise safety but also wellbeing for everyone.

Sections cover: infection control, communications, supporting service users, carers, staff and volunteers, and yourself, some final things people are likely to want to consider doing before re-opening, and there is a practical scenario planning tool.  At the end are source documents and further resources.

Part 2 is a Word document that aims to prompt reflection on what has happened during lockdown, what else you may wish to think about, the process of moving forwards and any learning that will be helpful for the future. Individual sections can be completed according to the stage you are in. It reflects the strong evidence that day centres are valued by the people who attend and that they improve their quality of life. They help people to stay living at home and provide family members with help in their caring role. They play an important part in preventing loneliness and social isolation. They can and should be part of the nation’s recovery from Coronavirus.

Feedback

Please let us know if you have found these documents useful or can suggest any changes.
We are interested in documenting how the Coronavirus or Covid-19 pandemic is impacting on day centres.

Further information about our ARC South London work and our work on day centres

Please address any feedback or comments to: Katharine.Orellana@kcl.ac.uk

This project is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Fair Care Work: A Post COVID-19 Agenda for Employment Relations in Health and Social Care

Ian Kessler, Stephen Bach, Richard Griffin and Damian Grimshaw introduce their new paper, Fair care work. A post Covid-19 agenda for integrated employment relations in health and social care, published yesterday by King’s Business School. Lead author, Professor Kessler, is Deputy Director of the NIHR Policy Research Unit in Health and Social Care Workforce. (908 words)

The courage and sacrifice of the health and social care workforce have emblazoned themselves on the national consciousness as the challenge of COVID-19 continues. While classified as ‘key workers’, along with other occupations essential to the community in times of crisis, the distinctive contribution of frontline care workers, reflected in their direct and relentless engagement with the virus, has until recently been reflected in the Thursday night applause reserved for them. This public applause sits uneasily, however, with the treatment of over two million health and social care employees, mostly women, often from black and minority ethnic backgrounds, typically in undervalued, relatively low paid and insecure employment. In a new paper, we seek to kick start a policy debate on the development of fair care work, to stimulate discussion on a refreshed employment relations (ER) agenda which acknowledges and reflects the worth of care workers to our individual and communal well-being. Continue reading

The Challenge of Self-Isolating in Houses in Multiple Occupation (HMOs)

Emily HillIn this blog, Emily Hill from Harbour Housing, a homeless charity in Cornwall, describes how their service has supported people living in temporary accommodation to leave hospital safely during the pandemic. She highlights some of the challenges in making sure everyone has the opportunity to self-isolate when living in a House in Multiple Occupation (HMO) (903 words)

Harbour Housing provides supported accommodation across Cornwall for people with multiple and complex needs, including those who have recent experience of homelessness. The accommodation is provided in what are called Houses in Multiple Occupation (HMOs). Residents have their own rooms but share communal areas such as bathrooms and kitchens.

Clinical advice and guidance on reducing the risk of infection and severe illness among the homeless population as a result of coronavirus (COVID-19) is clear that HMO’s could pose risks. In order to reduce these risks, the guidance suggests that individuals should be provided with their own room and bathroom facilities wherever possible. Where this is not possible, providers should make best use of provision and should undertake regular cleaning of shared facilities.

Hygiene zoneThe first step in Harbour Housing’s response to keeping residents safe from COVID-19 was to provide everyone with an information briefing, ensuring staff had time to talk through any concerns. Video screens in the properties also relayed NHS advice about hygiene and hand washing. Washing facilities and hand dryers were installed in the entrance lobby at each building. This meant that everyone had the opportunity to wash their hands before entering the property. In addition, thermal imaging CCTV cameras were installed to read the temperature of every person entering the building. This was to ensure that symptoms could be caught early. Continue reading

Action on Elder Abuse is now Hourglass

Richard RobinsonAction on Elder Abuse recently relaunched as Hourglass. As a research team we at HSCWRU have long taken a strong interest in this area, so we are very pleased to post this piece by Richard Robinson, CEO of the charity, in its new guise, and as it nears its 30th birthday. (760 words)

On 24 March 2020, as a nationwide lockdown was announced in a bid to protect UK citizens from the coronavirus pandemic raging across the world, Action on Elder Abuse relaunched under the name Hourglass.

While the timing was extremely challenging, the rebrand was a necessary effort to mark the start of the charity’s new course as a modern, public-facing organisation building on our almost thirty years of experience. If we were to modernise and become sustainable as a charity, we had to redefine ourselves so that we could successfully champion safer ageing and break down the barriers that foster age-related vulnerability.

The Hourglass mission is simple: end the harm, abuse and exploitation of older people in the UK. Continue reading

How are older people coping with digital technology during the COVID-19 pandemic?

Dr Nayyara TabassumDr. Nayyara Tabassum is Evidence Officer in the Centre for Ageing Better. (749 words)

Online grocery shopping has made lives very easy. With just a few clicks, you can order everything from a fridge to hand sanitisers (if there’s any in stock!). But I didn’t realise how challenging that could be for some sections of people. A couple of days back, while chatting with my 76-year-old neighbour John, he mentioned how difficult it was for him to place online grocery orders. As a first-time online banking user, his card activity was flagged as suspicious and by the time he managed to get verified, he lost his delivery slot.

There are so many older people like John who have had to rely on using the internet for the very first time during the COVID-19 pandemic. Banks need to make the authentication processes easier, especially for first time digital shoppers. According to 2019 ONS figures on internet users, almost half the UK population of people at 75 and over (47%) have never used the internet. The fact that John uses the internet at all is quite fortunate. The good news is that internet use in the 65-74 age group is increasing – it rose from 52% in 2011 to 83% in 2019, and the current situation is likely to speed that increase. Continue reading

The COVID-19 Effect On Flexible Working: The Good, The Bad, The Ugly

Dr Nayyara TabassumDr. Nayyara Tabassum is Evidence Officer in the Centre for Ageing Better. (828 words)

In the UK, as soon as the lockdown was announced by Boris Johnson in his televised address on 23 March 2020, one of the first things a lot of employers did was to announce that all staff would need to start working flexibly, with immediate effect. Overnight, companies that did not even have a flexible working policy, reviewed their policies and allowed employees to start working from home.

Research vs Pre-COVID Reality

While research has always shown the business benefits of flexible working on employee productivity and wellbeing, there was not enough buy-in from employers and there were lots of misconceptions and stigma attached to flexible working.

Now with the COVID-19 outbreak, employers have wholeheartedly adopted technology for staff to continue working remotely during lockdown. Job sectors, such as the insurance and banking sectors, which were previously quite averse to flexible working, also allowed staff to work flexibly during the lockdown. The results of this flexible working experiment thanks to the pandemic was that a lot of job sectors are now acknowledging that businesses can continue as usual even when staff work flexibly from home. Continue reading

Embracing New Technology and Social Media to Prevent Homelessness: How COVID-19 is impacting on support workers in the criminal justice system

In this post, Stan Burridge, Director of Expert Focus (a user-led consultancy), reports on how COVID-19 is impacting on workers who support people leaving prison to find accommodation and resettle in the community. He speaks to two workers from the Cumbria Offender Service run by Humankind, a medium-sized voluntary sector organisation based in the north of England. (1,388 words)

Thinking about your job before the lockdown, what is your normal role like?

There are a number of different roles I play supporting offenders who have either been released after serving a prison sentence or as part of a community-based sentence involving probation. All of my work fits into the wider picture of helping them to find a stable platform (securing accommodation and claiming benefits is part of that process) so they can engage with other services as part of their sentencing commitments but also as a way of moving forward and hopefully away from committing crime.

What are the difficulties in finding accommodation for people leaving prison, especially as housing is at a premium?

There is a real difficulty in getting people housed and in an ideal world everyone who was released from prison would have somewhere to go, but that is not the case. Often when accommodation is found it is in areas where there is a lot of crime and drug use, so it seems as though we are often perpetuating people’s problems. Options to place people in less deprived areas are limited and the harsh reality is if I couldn’t get someone housed in those sorts of areas, I probably wouldn’t be able to get them housed anywhere, so they would be homeless. Continue reading

COVID-19 pandemic – the view from Australia

Dr Bernadette Moorhead is Lecturer in Social Work and Human Services at the Wagga Wagga campus of Charles Sturt University in New South Wales, Australia. This is the first in a series of dispatches from the academic social work community across the world as services adapt to conditions under the COVID-19 pandemic. (309 words)

Hello from Australia,

To say that social workers have faced major challenges in recent months in Australia is perhaps an understatement. The community services sector was already under significant strain at the beginning of this year, as practitioners were on the frontline of support for families and communities devastated by unprecedented bushfires. Disaster recovery and ecosocial work have been growing areas of practice in Australia, and certainly will continue to be as many communities, especially in rural and regional areas, try to recover from the trauma of the bushfires, as well as the impacts of the COVID-19 pandemic that has decimated many local economies.

Despite these crises, we are seeing a great deal of innovative practice, as well as collective action, with Australian social workers making extensive use of online platforms to share resources, provide updates and deliver professional development opportunities. Face to face contact with client groups continues in many fields, especially child welfare (in line with social distancing provisions). We have also seen a major increase in the use of technology to stay connected with service participants. An important and much needed injection of government funds across the sector has been used by some organisations to purchase devices for client groups, such as iPads and phones, in order to enhance their access to support services.  However, there are still large gaps in infrastructure across the country, which makes accessing the internet a challenge for many, especially disadvantaged communities. The need for further advocacy and community development practice that improves infrastructure so that people can stay connected is at the forefront of our minds.

If you are interested in hearing more here is a 6 min podcast by the National President of the Australian Association of Social Work, Christine Craik.

Take care everyone and stay safe.

Bernadette Moorhead, Charles Sturt University, Wagga Wagga, Australia.

Dr Moorhead recently co-authored an article with Jill Manthorpe and Mary Baginsky: An Examination of Support and Development Mechanisms for Newly Qualified Social Workers Across the UK: Implications for Australian Social Work, Practice, 32:2, 145-159.

Wagga Wagga, NSW, Australia

This is the first in a series of dispatches from the academic social work community across the world as services adapt to conditions under the COVID-19 pandemic. The series is co-ordinated by Dr Mary Baginsky, Senior Research Fellow at the NIHR Policy Research Unit in Health and Social Care Workforce, King’s College London. See a listing of this Unit’s COVID-19 related work.

Child and family welfare services: where do we go next?

Dr Carl Purcell, NIHR Health and Social Care Workforce Research Unit, King’s College London. His book, The Politics of Children’s Services Reform: Re-examining Two Decades of Policy Change, is just out. (849 words)

As we emerge from the current crisis, we must rethink how we resource and deliver child and family welfare services. The incredible contribution made by everybody working in the NHS is now widely appreciated. But we must remember that there are many others working to protect the most vulnerable in our society who also deserve our recognition. Furthermore, as we move, tentatively, towards easing the lockdown the skills, knowledge and dedication of teachers, childcare workers and social workers, to name just a few, will be vital to ensuring that we are able to identify and support the most vulnerable children and families.

However, as we place greater demands on schools, local authorities and a vast array of voluntary sector agencies we must recognise that before the current crisis our child and family welfare system was already under significant strain. In my new book I reflect upon recent national policy developments to help explain how we arrived in this position. As we chart a way forward, three aspects of the contemporary system need to be addressed.

First, we need to reconsider the extent to which, and how, we provide financial assistance to those who need it most. Since 2010 welfare payments and tax breaks offered to the poorest families have been reduced or withdrawn. Progress made in reducing child poverty over the preceding decade has been reversed, with over 4 million children now living in poverty, many of them in working households (Joseph Rowntree Foundation, 2018). Moreover, the current crisis has demonstrated how precarious and insecure many people’s jobs are, and we have seen record increases in benefit claims. Many more families have been pushed beneath the poverty line.

Second, more resources are needed to fund the child and family welfare services we need to help us identify and support the most vulnerable children and families. In response to rising demand and declining budgets, local authorities have been forced to prioritise spending on specialist children’s social care services over the last decade to ensure that they can respond to the most serious cases of child abuse and neglect. But this has meant that funding for universal ‘early intervention’ services such as children’s centres and youth services has been almost cut in half (Action for Children et al 2019). Our capacity to identify and respond to families most in need of support, and before more draconian interventions are necessary, is greatly diminished at a time when it is needed most.

Third, it is imperative that the design and delivery of services must involve those who lead welfare agencies, those working on the frontline, and children and families themselves. They are best placed to understand what is needed and to advise on how we can make best use of the resources available. Recent reforms to children’s services have been too top-down and have tended to view organisational restructuring as a magic bullet. Labour’s Every Child Matters programme required the break-up of social services departments and the creation of new children’s services departments in every local authority. More recently, Conservative ministers have promoted the outsourcing of children’s social care services in response to apparent ‘failings’ at the local level. In both cases concerns raised by those working in the sector were largely ignored, and valuable resources have been diverted. Yet bold promises made by ministers to fix the system are never delivered.

If we look further back to the development of the Children Act 1989, which continues to provide the legal cornerstone for child and family welfare services even after three decades of subsequent reform, valuable lessons can be learned. This legislation, developed under a Conservative Government, involved extensive research involving those working to support children and families, supported but not micro-manged by central government. Going forward, we must pool our resources and ensure that government policymakers, researchers and those working directly with children and families all pull in the same direction.

Carl Purcell (2020) The Politics of Children’s Services Reform: Re-examining Two Decades of Policy Change (Bristol, Policy Press) is published on 29 April 2020.

Reviews

“Erudite and relevant to all immersed in helping children and families. It gives a riveting account of developments and debates and describes the journey which has created the context for today’s children’s services. An impressive book that will have currency well into the future.” Ray Jones, Kingston University and St George’s, University of London

“This book is a ‘must read’ for anyone interested in recent child welfare policy. Drawing on an impressive range of high level interviewees, Purcell provides a readable and coherent account of child welfare policy making with valuable insights that illuminate the contemporary situation.” Nick Frost, Leeds Beckett University

References

Action for Children, National Children’s Bureau, NSPCC (National Society for the Prevention of Cruelty to Children), The Children’s Society and Barnardo’s (2019) ‘Children and young people’s services: funding and spending 2010/ 11 to 2017/ 18’.

Joseph Rowntree Foundation (2018) ‘UK poverty 2018’.

From desk to doorstep

Living well with dementia is important, though there may come a time when initiating social contact becomes a challenge. For some people living with dementia there may be increased isolation. For those living with a partner or family and friends, as dementia progresses their daily care needs may be hard to manage or support.

Attending a day service which offers stimulating activities, whilst at the same time providing respite for family carers, benefits not only the person with dementia, but also helps families continue their support.

The COVID-19 lockdown brought an end to this overnight.

Foreseeing the psychological or emotional consequences of the loss of day centre support, one day centre has switched to offering daily support via phone calls to its former attenders and their carers. Additionally, as day centre staff have great experience in providing ‘customer care’ to relatives, they quickly became part of the COVID-19 Emergency Shielding Residents Response. Continue reading