Understanding the lived experiences of infection-control measures in care homes for older people: joint findings from a completed study and a related, on-going study

Presenter: Kathleen Lane (School of Health Sciences, University of East Anglia)

Abstract for the International workshop on COVID-19 and Long-Term Care systems: What have we learnt and what policies do we need to strengthen LTC systems?, 6 and 7th December 2021

Abstract:  

Context:  Infection-Control Measures (ICMs) to control COVID-19 have had an impact on care and staff morale. 

Objectives:  To explore care-home staff’s lived experiences in implementing and coping with ICMs. 

Methods:  Mixed-methods, to date comprising 778 online survey responses and 20 in-depth interviews with UK care-home staff across both studies. 

Results:  Study 1 interview data, three themes identified:  Integrating COVID-19 ICMs with caring; Conveying knowledge and information; Professional and personal impacts of care-work during the pandemic.  Fatalistic attitudes towards COVID-19 infection were present.  Challenges of providing care using personal protective equipment (PPE), especially for residents with dementia, were highlighted.  Interviewees reported dilemmas between implementing ICMs strictly and providing best care to residents while preserving personal space.  Official guidance was reported as confusing, constantly changing and ill-suited to care homes.  ICM training was undertaken using multiple techniques but with little evaluation of them or how to sustain behaviour change. Survey data (studies 1 and 2):  mostly good morale, job satisfaction and adherence to ICMs were reported.  Non-care workers reported the most anxiety at work in Study 2.  Working in other settings with vulnerable people was common.

Implications:  COVID-19 has had a profound effect on care-home staff’s well-being.  Despite sustained challenges, participants reported broadly good morale, potentially a consequence of supportive colleagues and management.  Nevertheless, clear, concise and care-home focussed ICM guidance is needed, as are evidence-based assessments on implementing and sustaining adherence.  Groups of care-home staff and ICM experts working together to co-create, interpret and implement guidance were viewed positively.

Explanatory note:  Data collection for Study 1 undertaken Nov. 2020 – Jan. 2021 involving care-home staff. Study 2 commenced June 2021 and includes residents and family/friends of residents as well as care home staff.  This joint paper focuses on the experience of care-home staff only.

List of authors – Study 1, conducted Nov. 2020 – Jan. 2021

Diane Bunn:    School of Health Sciences, University of East Anglia (UEA), Norwich

Julii Brainard:  Norwich Medical School, UEA 

Kathleen Lane:  School of Health Sciences, UEA 

Charlotte Salter:  Norwich Medical School, UEA 

Iain Lake:        School of Environmental Sciences, UEA

List of authors – Study 2, on-going

Kathleen Lane:   School of Health Sciences, University of East Anglia (UEA), Norwich

Julii Brainard:  Norwich Medical School, UEA 

Diane Bunn:    School of Health Sciences, UEA 

Julie Houghton:  PPI/Carer 

Anne Killett:    School of Health Sciences, UEA 

Suzanne Mumford:  Care UK 

Sarah O’Brien:  School of Natural and Environmental Sciences, Newcastle University 

Laura Watts:  School of Health Sciences, UEA 

For more information:

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